Anal
Warts (Condyloma)
Venereal
warts are sexually transmitted diseases that infect the anal and
genital areas. They usually spread from person to person by sexual
contact. They can also spread from inanimate objects, such as a
shared bath towel. Approximately two-thirds of people who have sexual
contact with a partner with genital warts will develop warts, usually
within three months of contact. Scientists estimate that as many
as 1 million new cases of anal and genital warts are diagnosed in
the United States each year. There are two types of venereal warts,
condyloma accuminatum and condyloma latum.
Condyloma Latum
Condyloma
latum are reddish, moist warts, and are a sign of secondary syphilis.
These warts are treated by treating the underlying syphilis infection
with antibiotic.
 
Condyloma Accuminatum
Condyloma accuminatum are pink to whitish growths that occur on
the anus and genitalia as a result of infection with the papilloma
virus. The Human Papilloma Virus (HPV) is one of the most common
viral sexually transmitted diseases (STD) in the United States
today. As many as one in five American adults has a genital HPV
infection. They occur on the penis, the vagina, the anus, and
rarely, the mouth. In the anal area they may be mistaken for hemorrhoids.
They are spread by contact with the wart, which actively sheds
viral particles. They grow geometrically and may become extensive.
(Warts on other parts of the body, such as the hands, are caused
by different types of HPV. Contact with these warts does not seem
to cause genital warts.)
Treatments
are directed as destruction of the wart tissue to allow for normal
healing. Some work has been done with immunotherapy and a commercial
preparation of alpha interferon is available. The alpha interferon
is injected into the wart which stimulates an immune response
causing the wart to disappear. The problem with the therapy is
the alpha interferon is quite expensive and doesn't work in all
cases. Imiquimod cream is a self-applied immune response modifier
that induces local production of interferon in patients with external
genital warts.
Though
genital warts can be treated, none of the available treatments
are a cure for HPV. The virus can remain in nearby skin after
treatment. Because the virus can lie dormant in the cells, in
some cases warts can return months or even years after treatment.
In other cases, warts never recur.
More
reliable is wart destruction. This may be accomplished chemically
with an acid compound, liquid nitrogen, or with surgery. The acid
compounds are chemical cauterants which burn off the wart. Cryotherapy,
or the application of liquid nitrogen to the wart tissue destroys
it by freezing it. Warts may also be destroyed by electrocautery
or vaporization with a CO2 laser. This is done as an outpatient
at a hospital or a outpatient surgical facility. Even with surgical
destruction of all warts the patient must still be carefully followed
for the development of recurrence. At the time of surgery all
visible warts are destroyed but it may take up to 30 days before
infected tissue shows signs of wart development. It is therefore
very important that prolonged follow-up be performed to assure
cure.
Photo
References
1. Picture: Condyloma Accuminatum - Dr. E. Brender
http://home.talkcity.com/SupportSt/drbrender/Butt_Doctor/Venereal_Warts.htm
2.
Picture: Condyloma Latum - Dr. J. Bezzant
http://www-medlib.med.utah.edu/kw/derm/pages/pa04_4.htm
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