American Urological Association - Condyloma Acuminatum
- Etiologic agent: Human papilloma virus.
- Clinical features: typically a disease of young adults; most cases are sexually transmitted; presence in children suspects child abuse.
- Incidence: involves ~5% of men in 20s to 40s.
- Incubation period: variable, ranging from weeks to months to years.
- Gross features: flat, warty, papillary or cauliflower-like lesions usually on glans or penile meatus, but may be seen on scrotum, and perineum as well as perianal region.
- Papillomatosis, hyperkeratosis (thickened keratin layer), parakeratosis (keratin layer with pyknotic nuclei) and koilocytes (raisinoid cells within a clear "halo") are characteristic features (image A), (image B), (image C) & (image D).
- Penile condylomas are usually cytologically benign, although treatment with podophyllin or lasers may cause marked cytologic atypia – a history of prior treatment is therefore always appreciated.
- Viral strains 6 and 11 are common in typical condyloma without dysplasia, while strains 16, 18, 31 and 33 are more common in the dysplastic forms of condyloma.
- Prognosis and treatment: may spontaneously regress (50%); recurrence is common; otherwise treat with podophyllin or laser.