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

www.hpv.org.nz