Human Papillomavirus (HPV) Differential Diagnoses

Updated: Feb 20, 2020
  • Author: Peter A Gearhart, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Diagnostic Considerations

Failure to diagnosis genital warts correctly can result in considerable morbidity. Confusing condylomata lata for genital warts will miss the diagnosis of syphilis and will lead to inappropriate therapy. Confusing pearly penile papules or Fordyce spots with genital warts will result in unnecessary treatment and likely unwarranted psychosocial concern. Missing a diagnosis of verrucous carcinoma or squamous cell carcinoma is likely to delay appropriate therapy and may lead to needless morbidity or even mortality.

Most papillomas are sufficiently distinct to be clinically recognizable. Bowenoid papulosis may be mistaken for lichen planus, psoriasis, seborrheic keratoses, or condylomata acuminata.

In additions to the conditions listed in the differential diagnosis, other problems to be considered include the following:

  • Acanthosis nigricans

  • Acrochordon

  • Actinic keratoses

  • Anogenital malignancy

  • Anogenital warts in children

  • Bowenoid papulosis

  • Carbon dioxide laser surgery for intraepithelial cervical neoplasms

  • Cervical polyp

  • Condyloma latum

  • Corns and calluses

  • Dermatitis papillaris

  • Endoscopic gynecologic surgery

  • Epidermodysplasia verruciformis

  • Fordyce spots

  • Hymenal remnants

  • Hypopigmentation

  • Keloid and hypertrophic scar

  • Keratoacanthoma

  • Laryngeal papillomatosis of neonates and infants

  • Malignant tumors of the mobile tongue

  • Micropapillomatosis labialis

  • Nevi

  • Pap test

  • Pityriasis versicolor

  • Psoriasis (plaque)

  • Recurrent respiratory papillomatosis

  • Seborrheic keratosis

  • Sinonasal papillomas, treatment

  • Skin tags (fibroepithelial polyps)

  • Verrucous carcinoma

  • Vestibular papillomatosis

Differential Diagnoses