Signs, Symptoms, and Presentation
Condyloma Acuminatum (CA) is caused by the human papillomavirus (HPV) and essentially is genital warts, skin growths that are not malignant. The causative agent, HPV, is, however, the same agent that causes cervical cancer (Matteucci & Schub, 2011). The warts present as growths or bumps in the anogenital region or in the anal canal and rectum. (Matteucci & Schub, 2011). It is sexually transmitted in general (i.e., an STD). Men see the warts on the penis, scrotum, groin, or thigh; women see the warts in the cervix, vulva, vagina or anal regions. If oral sex is involved, warts can also develop in the mouth or throat. Sometimes pain, discharge, bleeding or wetness is present (Matteucci & Schub, 2011). Occasionally, children develop CA, in which case sexual abuse issues should be considered but is not diagnostic for abuse (Pegues, 2010).
Prevalence and High Risk Groups
As an STD, the high-risk group are those who are sexually active. People in the 17-22 age range are the most at risk (Matteucci & Schub, 2011). Sex with multiple partners, having another STD, unprotected vaginal sex, early sex, smoking, immunosuppression, and using oral contraceptives also increase risk of CA (Watkins, 2008). Women who received the HPV vaccine are far less at risk for CA as well, with the incidence declining significantly since that vaccine became available (Matteucci & Schub, 2011).
Treatment depends in part on the patient preferences as well as on the characteristics of the warts (Matteucci & Schub, 2011). Note that it is very important that both (or all) partners be treated (Edwards, 2008). Various options done by medical professionals include surgery, cryotherapy, electrodesiccation, curettage, immune therapies. Patients can administer other therapies including various creams and ointments (imiquimod 5%; 5-flurouricil; sinecatechins 15%, podofilox 5%). Patients may also opt for no treatment, since CA may resolve on its own (Matteucci & Schub, 2011). In children under 12 there are no treatments available (Pegues, 2010). Since CA usually resolves in children without treatment, treatment would only be considered in the case of very large warts, or ones that persist for more than 2 years, or if the child is immunosuppressed (Pegues, 2010). Other treatment issues include addressing any discomfort , and soothing patient anxiety (Pegues, 2010).
Preventative Care and Patient Education
Preventative care includes practicing safer sex and using condoms (Edwards, 2008). Also, kissing a person with cold sores around the mouth may make transmission of HPV more likely (Edwards, 2008). If a woman is of appropriate age (9 to 26), receiving HPV vaccine may help (Pegues, 2010). CA is associated with strong psychological impact on patients, so education about CA is important to improve patient care (Mortensen & Larsen, 2010).