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Diagnostic Methods
Diagnosis of Genital Warts
Diagnosis of genital warts is usually made by visual
inspection with bright light; the diagnosis can be confirmed
by biopsy.
Confirmation of diagnosis is needed when:
- The diagnosis is uncertain.
- The patient is immunocompromised.
- Warts are pigmented, indurated, or fixed.
- The lesions do not respond or worsen with standard treatment.
- There is persistent ulceration or bleeding.
Acetic acid evaluation of external genitalia is of
limited value in routine clinical practice due to its low
specificity (many false-positives) and is not recommended
for evaluation of external genitalia. Use of type-specific HPV DNA tests for routine diagnosis and management of genital warts is not recommended.
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External genital warts are not an indication for cervical colposcopy.
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Differential Diagnoses for Genital Warts
Include:
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Other infections
- Condylomata lata - tend to be smoother, moist, more rounded, and darkfield-positive for Treponema pallidum; this is a manifestation of secondary syphilis and an RPR or VDRL and an FTA-ABS are positive.
- Molluscum contagiosum - papules with central dimple, caused by a pox virus; rarely involves mucosal surfaces.
Acquired dermatologic conditions
Normal anatomic variants
- "Pink pearly penile papules"
- Vestibular papillae (micropapillomatosis labialis)
- Skin tags (acrochordons)
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