eMedicine Specialties > Emergency Medicine > Infectious Diseases

Condyloma Acuminata: Differential Diagnoses & Workup

Author: Delaram Ghadishah, MD, Staff Physician, Encino Tarzana Emergency Department
Contributor Information and Disclosures

Updated: Dec 22, 2008

Differential Diagnoses

Molluscum Contagiosum
Rhabdomyolysis

Other Problems to Be Considered

Bowen disease
Condyloma lata
Darier disease
Fibroepitheliomas
Hailey-Hailey disease
Neoplasia
Nevi
Pearly penile papules
Squamous cell carcinoma in situ
Vulvar neurofibromatosis
Vulvar vestibular papillae

Workup

Laboratory Studies

  • As indicated by history and examination, test for other STDs, such as HIV, gonorrhea, chlamydia, and syphilis.
  • Although not ED tests, the following are listed strictly for educational purposes and to assist readers in understanding and managing potential complications:
    • Pap smear: This test is used to look for papillomatosis, acanthosis, koilocytic abnormality, and mild nuclear abnormality.
    • Filter hybridization (Southern blot and slot blot hybridization), in situ hybridization, and polymerase chain reaction (PCR): These tests may be used for diagnosis and HPV typing.
    • Hybrid capture

Other Tests

  • Acetowhitening
    • Subclinical lesions can be visualized by wrapping penis with gauze soaked with 5% acetic acid for 5 minutes.
    • Using a 10-X hand lens or colposcope, warts appear as tiny white papules.
    • A shiny white appearance of skin represents foci of epithelial hyperplasia (subclinical infection).

Procedures

  • Although not ED procedures, the following are listed strictly for educational purposes and to assist readers in understanding and managing potential presenting complications:
    • Colposcopy (stereoscopic microscopy): This is very useful to identify (mostly) cervical lesions, which are identified better using acetic acid.
    • Biopsy: Biopsy is indicated for lesions that are atypical, recurrent after initial success, or resistant to treatment or in patients with a high risk for neoplasia or immunosuppression.
    • Anoscopy
    • Antroscopy

More on Condyloma Acuminata

Overview: Condyloma Acuminata
Differential Diagnoses & Workup: Condyloma Acuminata
Treatment & Medication: Condyloma Acuminata
Follow-up: Condyloma Acuminata
Multimedia: Condyloma Acuminata
References
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References

  1. Chan PD, Winkle PJ, Winkle CR. Condyloma acuminata. In: Current Clinical Strategies - Family Medicine. 2nd ed. Current Clinical Strategies Publishing Inc; 1995:209-210.

  2. Congilosi SM, Madoff RD. Current therapy for recurrent and extensive anal warts. Dis Colon Rectum. Oct 1995;38(10):1101-7. [Medline].

  3. Friedman M, Bayer I, Letko I, Duvdevani R, Zavaro-Levy O, Ron B, et al. Topical treatment for human papillomavirus-associated genital warts in humans with the novel tellurium immunomodulator AS101: assessment of its safety and efficacy. Br J Dermatol. Sep 19 2008;[Medline].

  4. Garrido JL. Human papilloma virus--H.P.V. condyloma. Current studies in diagnosis, treatment and prognosis. Clin Exp Obstet Gynecol. 1996;23(2):99-102. [Medline].

  5. Hoory T, Monie A, Gravitt P, Wu TC. Molecular epidemiology of human papillomavirus. J Formos Med Assoc. Mar 2008;107(3):198-217. [Medline].

  6. Kodner CM, Nasraty S. Management of genital warts. Am Fam Physician. Dec 15 2004;70(12):2335-42. [Medline].

  7. Leung AK, Kellner JD, Davies HD. Genital infection with human papillomavirus in adolescents. Adv Ther. May-Jun 2005;22(3):187-97. [Medline].

  8. Mayeaux EJ, Harper MB, Barksdale W, Pope JB. Noncervical human papillomavirus genital infections. Am Fam Physician. Sep 15 1995;52(4):1137-46, 1149-50. [Medline].

  9. Poolman EM, Elbasha EH, Galvani AP. Vaccination and the evolutionary ecology of human papillomavirus. Vaccine. Jul 18 2008;26 Suppl 3:C25-30. [Medline].

  10. Prasad CJ. Pathobiology of human papillomavirus. Clin Lab Med. Sep 1995;15(3):685-704. [Medline].

  11. Sinal SH, Woods CR. Human papillomavirus infections of the genital and respiratory tracts in young children. Semin Pediatr Infect Dis. Oct 2005;16(4):306-16. [Medline].

  12. Sykes NL. Condyloma acuminatum. Int J Dermatol. May 1995;34(5):297-302. [Medline].

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Further Reading

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Keywords

condyloma acuminata, genital wart, human papillomavirus infection, HPV infection, HPV type 6, HPV-6, HPV type 11, HPV-11, bowenoid papulosis, seborrheic keratoses, Buschke-Löwenstein tumors, giant condyloma, carcinoma in situ, sexually transmitted disease, STD, genitourinary cancer, vulvar condyloma acuminata, warts of penile urethral meatus, acute urethral obstruction, smoking, oral contraceptives, multiple sexual partners, painless bumps, coital bleeding, papular eruptions, Papanicolaou tests, Pap tests

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Contributor Information and Disclosures

Author

Delaram Ghadishah, MD, Staff Physician, Encino Tarzana Emergency Department
Delaram Ghadishah, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Medical Editor

William K Chiang, MD, Associate Professor, Department of Emergency Medicine, New York University School of Medicine; Chief of Service, Department of Emergency Medicine, Bellevue Hospital Center
William K Chiang, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Medical Toxicology, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Barry J Sheridan, DO, Chief, Department of Emergency Medical Services, Brooke Army Medical Center
Barry J Sheridan, DO is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP, Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, University Hospitals, Case Medical Center
Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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