Usually asymptomatic but occasionally painful or pruritic – can be flat, popular or pedunculated.
HPV transmission is from direct skin-to-skin contact with apparent or subclinical lesions. Microabrasions in the recipient skin allow viral access to the basal cells of the epithelium.
Most HPV infections are asymptomatic.
Most common types are HPV 6 and 11.
Similar to HSV, the long latency period does not imply that the virus was caught recently.
Can occur urethrally causing symptoms.
Consider screening for other STIs on presentation.
Treatment is cosmetic (not curative):
Avoid shaving – may spread the virus and cause entry points
Consider biopsy if not resolving/responding to treatment, progressing, or any suspicion of malignancy.
Podophyllin (condyline paint)
- Antimitotic agent preventing cell division and causing cell death
- Over the counter creams or paints
- Apply BD for 3 days then weekly to lesions
- May be expensive and hard to find
- Approx 50 % resolution
Imiquimod (Aldara)
- Stimulates local cytokine reaction and immune response
- Apply 3 x week
- Topical reactions not uncommon – can skip a dose
- Occasional flu-like symptoms
- Better for thinner skin (glans) – less effective on thicker skin (shaft)
- Approx 50 % resolution
Diathermy / excision ; Cryotherapy ; Observation and reassurance is acceptable