Venereal warts.

Abstract

Clinically visible venereal warts are only one manifestation of the much larger problem of HPV infection, which may be the most common venereal disease if subclinical infections are considered. HPV infection probably is undiagnosed in at least 80% of cases because subclinical infection can be identified only by acetic acid application, magnification, Pap smears, or molecular DNA hybridization techniques applied to cytology or biopsy specimens. Genital HPV is present in up to 35% of some populations and in 6-11% of both men and women with clinically normal genitalia. Patients and their sexual partners should be monitored for cervical carcinoma and other epithelial malignancies associated with HPV infection. Although visible lesions can often be eradicated with the many available therapies, it is unlikely that all HPV can be destroyed where it has been incorporated into the DNA of clinically normal epithelium. Therefore, excessively vigorous, painful therapy is probably unwarranted.