Telltale skin lesions of syphilis, gonorrhea, human papillomavirus infection, and Haemophilus ducreyi infection.
Between 15 and 20 large, asymptomatic, cauliflowerlike condylomata had been present for several years on the penile shaft of a 52-year-old uncircumcised man. The patient and practitioner were concerned about the oncogenous potential of the human papillomavirus (HPV) that causes these warts. The likelihood of penile condyloma transformation to squamous cell carcinoma is much greater in uncircumcised men than in those who have been circumcised. In addition, the patient feared transmitting HPV to his female partners; HPV infection increases the risk of cervical cancer in affected women.
The warts were removed by shave excision and electrodesiccation, as shown in the photograph. Histopathologic examination of tissue ruled out cellular atypia; reactive plasma reagent test results were negative for condyloma latum.
The patient was counseled about the high probability of wart recurrence and the need to treat the condylomata with liquid nitrogen several times a year to control the disease.
(Case and photograph courtesy of Joe Monroe, PA-C.)
1. Crum CP. The beginning of the end for cervical cancer? N Engl J Med. 2002;347:1703-1705.
2. Ryan KJ, Berkowitz RS, Barbieri RI. Dunaif A. Kistner's Gynecology and Women's Health. 7th ed. St Louis: Mosby; 1999:101.
3. Koutsky LA, Ault KA, Wheeler CM, et al. A controlled trial of a human papillomavirus type 16 vaccine. N Engl J Med. 2002;347:1645-1651.