Condyloma accuminatum - condylomata
Condyloma accuminatum or venereal warts or giant condyloma is a contagious viral disease affecting the genital area. It is caused by the human papillomavirus, commonly known as HPV. Condyloma accuminatum is a sexually transmitted disease. Most affected groups include young women around twenty and homosexual men.
HPV or human papillomavirus is a virus common in our population, transmitted by sexual intercourse. It is reported that 80-90% of sexually active adults are infected by this virus. Under normal circumstances, the immune system of the body can cope with the virus. The problem is that there are about 100 types of HPV virus and some of them cause especially cervical cancer in women, as well as cancer of the vulva or external female genitals and the vagina. In men, HPV virus can cause penile cancer. HPV virus causes genital warts or condyloma accuminatum in both sexes.
Symptoms of condyloma accuminatum
Over a lifetime up to 80% of people get infected with HPV, but only a small percentage of the infections occur in the form of warts. HPV virus multiplies in the point of entry, usually on the mucous membrane or in tiny cracks in the genital skin. Condylomata are tiny whitish to red polyps that bleed easily when injured. They can occur either solely, but mostly they are multiple. They can grow and merge together. When neglected or poorly cared and in people with an impaired immune system the warts become to have a cauliflower-like appearance. In men they appear on the preputial sac, the inner side of the foreskin covering the glans penis, on the frenulum of the foreskin, the glans penis itself and external urethral meatus. Exceptionally condylomata accuminatum grow all over the male penis and forms a so-called condyloma giganteum. In women they are present on large or small labia lips, the clitoris or the uterine cervix. Outside the genitalia they may be localized in the area of the anus and perineum, the area between the anus and the genitalia. The occurrence of condyloma accuminatum is not rare e.g. in the corner of the mouth, between fingers and other areas related to diverse sexual activity. The first symptoms appear quite late, in the range 1 to 6 months.
Treatment of condyloma accuminatum
Recognizing condyloma accuminatum is easy, because it has a typical appearance. Condyloma accuminatum in men can be confused with naturally occurring spots around the glans penis, which is expertly known as papillae coronae glandis and certainly is not a cause for concern. Treatment of condyloma accuminatum is always difficult, and belongs in the hands of doctors. Growths can be either surgically removed (scalpel, laser, freezing, etc.) or cytotoxic substances are carefully applied. Cytotoxic agents are cell poisons that prevent cell division. In some places where condyloma accuminatum is small, it can be quickly scratched out by a sharp surgical spoon. A novelty is an imiquimod treatment. It is a cream that is applied to the affected areas. This form of treatment has good results, and reduces the risk of relapse. During pregnancy, if a woman has symptoms of condyloma accuminatum she can infect the newborn during birth. The newborn can develop a respiratory tract disease, the so-called laryngeal papillomatosis. It is the formation of small benign tumors in the larynx of a child. This impairment may lead to respiratory problems, and usually requires repeated surgical treatment, because after removing the small tumors, they usually grow back. It is not a common disease. Yet if a pregnant woman has genital warts or condyloma accuminatum present it should be a reason to consider terminating the pregnancy by caesarean section.
Prevention of condyloma accuminatum
The only reliable protection is sexual abstinence. Condoms provide a high level of protection, but HPV virus can be present in the skin in the areas that are not protected during sexual intercourse and the virus can be transmitted. Even sexual intercourse with a partner who does not have condyloma accuminatum does not guarantee that he does not have a hidden HPV infection and that he is a propagator. In recent years, a possibility in prevention is vaccination. The vaccine contains antibodies not only against the strain of HPV virus that causes warts, but also against his "friends" who are responsible for serious disease in women, like cervical cancer.