Pregnancy may also be associated with larger and more numerous warts. The incidence of warts is increased in immunosuppressed individuals. HPV is most commonly transmitted by sexual contact and transmission can occur regardless of the clinical manifestations. The incubation period is variable and may be prolonged. The existence of infectivity and infection in the absence of symptoms make interruption of transmission extremely difficult.
Transmission can also occur perinatally.
TOP OF PAGE Clinical features Warts fleshy growths around genitalia, around the anus and within the anal canal single or multiple lesions most commonly occur at sites of trauma at sexual intercourse those on non-hair bearing skin tend to be soft, those on hairy skin tend to be firm and keratinised may be broad based or pedunculated may be pigmented may be painful, pruritic or friable with bleeding if large, may interfere with normal function Occult lesions vagina, cervix, urethral meatus, anal canal Extragenital lesions oral cavity, larynx, conjunctivae, nasal cavity. They are a considerable management problem. TOP OF PAGE Diagnosis Diagnosis of anogenital warts usually based on direct examination of the typical lesion. If in doubt, it may be excised and examined histologically. This should be considered if the lesions are atypical, if there is ulceration or attachment to underlying structures, or if there are prompt or frequent recurrences.