Some practitioners use an acetic acid solution to help identify small warts and affected skin areas, but this practice is controversial.Ī biopsy is recommended if there is uncertainty about the diagnosis or if the patient is immunocompromised. Because genital warts are caused by low-risk HPV types, DNA tests should not be used for diagnosis or in low-risk HPV infections. Genital warts typically rise above the skin surface, have parakeratosis, and demonstrate nuclear changes typical of HPV infections (nuclear enlargement with perinuclear clearing). Small warts may sometimes be confused with molluscum contagiosum. The diagnosis of genital warts is usually made visually, although a biopsy may be necessary for confirmation. įor previously unvaccinated adults, the CDC suggests vaccinations for those 27 to 45 years of age.įor adolescents, the CDC suggests the vaccine be given at ages 11 or 12 years, but may be started as early as 9. Risk factors for HPV persistence include age, smoking, immunosuppression, and simultaneous infection with multiple HPV types. In men, Bowen disease of the penis and about 35% to 40% of all penile cancers are associated with HPV infections. (Cervical cancer is the fourth most common cancer in women.) Some vulvar cancers have been linked to HPV infections (29% to 43%), while vaginal cancer is associated with HPV infections about 70% of the time (HPV Types 16 and 18). HPV infection appears to be the cause of most cases of anal cancer (about 90%) and virtually all cases of cervical cancer in women, with HPV type 16 accounting for about 50% of these. However, it is now believed that the virus may be either cleared or suppressed to levels below what polymerase chain reaction (PCR) tests can measure. Traditional theories postulate that the virus remains in the body for a lifetime. Warts may sometimes spontaneously regress. It has been estimated that 2.9% of the US male population will have genital HPV DNA.Īlthough treatments can remove warts, they do not remove HPV. About 80% of those infected are between the ages of 17 and 33 years, with the peak age group being 20 to 24. The incidence of HPV infection has been increasing. Genital HPV infections have an estimated prevalence of 10% to 20%, with clinical manifestations in 1%.
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