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Clinical Manifestations and Sequelae
In most cases genital HPV infection is transient and has no
clinical manifestations or sequelae.
Manifestations of genital HPV infection include:
- Genital warts
- Cervical cell abnormalities
- Anogenital squamous cell cancers
- Recurrent respiratory papillomatosis
The two most common clinically significant manifestations of genital HPV are genital warts that can be visualized without magnification, and cervical
cell abnormalities that are detected by Pap test screening
(with or without HPV DNA testing) or
colposcopy.
Genital Warts
Genital warts have four morphologic types:
- Condylomata acuminata, which have a cauliflower-like appearance and may be skin-colored, pink, or hyperpigmented
- Smooth papules that are usually dome-shaped and skin-colored
- Flat papules that are macular to slightly raised, skin-colored, and have a smooth surface
- Keratotic warts, which have a thick horny layer that can resemble common warts or
seborrheic keratosis.
Genital warts commonly occur in areas of coital friction.
For men, this includes the penis, scrotum, urethral meatus,
and perianal area. For women, this includes the introitus,
vulva, perineum, and perianal area. Perianal warts do not
necessarily imply anal intercourse, but may be secondary to
autoinoculation, sexual activity other than intercourse, or
spread from a nearby genital wart site. Intra-anal warts are
seen predominantly in patients who have had receptive anal
intercourse.
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