Introduction
- 
most common viral infection 
- 
90% caused by HPV 6,11 - covered by HPV
 
Transmission:
- direct skin-skin
Symptoms
- 
asymptomatic to causing mulitple fleshy/flat lumps on genitals 
- 
lesions on vaginal walls and cervix may be noted during PV exam 
Management
- 
if extensive, atypical, intravaginal, cervical or uncertainty - refer
 
- 
Podophyllotoxin solution 0.5% bd for 3 consecutive days/week for 5 weeks appropriate for lesions which can be seen - 
not for vulval wart s or perianal warts - misapplication causes significant irriration
 
- 
men only 
 
- 
- 
Imiquimod cream 5% od tds for up to 16w - 
fully subs with SA - patients with warts not responsive to Podophyllotoxin or for use in more sensitive areas
 
 
- 
- 
Cryotherapy, - for small numver of warts
 
laser, diathermy, surgical excision may be options