Condyloma

Like other warts, subtypes of human papilloma virus also cause these lesions.  Like other warts, the infection is a lifelong one.  Sexually transmitted diseases such as condylomata love company.  Make sure that your patient does not have other STDs.  Evaluation for other STDs (e.g. syphilis, urethritis, and HIV) should be considered on the initial visit.

Once a patient has had condylomata, the skin always sheds virus to some degree.  As such, barrier contraception (e.g. condoms) is recommended unless a couple is actually trying to conceive.  The question of who gave the virus to whom is not a useful one.  The virus may have been shed asymptomatically by either partner for quite some time before lesions develop.  

The goal is to make your patient free of visible warts for as long as possible.  Eradication of the virus from the skin is impossible.  Destructive modalities delivered with precision such as liquid nitrogen, Trichloroacetic acid, electrosurgery, and podophyllin are helpful.

Podophyllin resin in tincture of benzoin has long been a mainstay of therapy.  Apply it to external lesions (do not apply to vaginal or cervical warts in women or use during pregnancy) and wash off with soap and water after 4 - 6 hours.  Re-evaluate your patient 1 week after treatment to determine whether additional therapy is necessary.

A new form of podophyllin (Condylox) is commercially available and should only be considered for emotionally mature, dexterous, and reliable patients.  The active ingredient is podofilox, a purified and standardized form of podophyllin toxin suitable for self-application by a patient.

Podofilox is meant only for external condylomata and should not be used on mucous membrane lesions or during pregnancy in females.  Follow the PDR recommendations carefully because over treatment will result in considerable irritation.   This should be applied only to lesional skin.  This medication is also quite expensive.  It is not meant for everyone.

Other pharmacologic means to treat condylomata include biologic response modifiers such as topical imiquimod cream (Aldara) and intralesional interferon.  These modalities are very costly and are only considered appropriate for treatment when prescribed by Dermatologists.

Written and revised by CAPT Dennis A. Vidmar, MC, USN, Department of Military and Emergency Medicine, and Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD (1999).

Additional images provided by CAPT Vidmar in June, 2000, subsequent to the initial publication of this manual.

Preface  ·  Administrative Section  ·  Clinical Section

The General Medical Officer Manual , NAVMEDPUB 5134, January 1, 2000
Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

This web version of The General Medical Officer Manual, NAVMEDPUB 5134 is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy version, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense. All material in this version is unclassified. This formatting © 2006 Medical Education Division, Brookside Associates, Ltd. All rights reserved.

Home  ·  Textbooks and Manuals  ·  Videos  ·  Lectures  ·  Distance Learning  ·  Training  ·  Operational Safety  ·  Search

Operational Medicine


This website is dedicated to the development and dissemination of medical information that may be useful to those who practice Operational Medicine. This website is privately-held and not connected to any governmental agency. The views expressed here are those of the authors, and unless otherwise noted, do not necessarily reflect the views of the Brookside Associates, Ltd., any governmental or private organizations. All writings, discussions, and publications on this website are unclassified.

© 2006 Medical Education Division, Brookside Associates, Ltd. All rights reserved

Other Brookside Products

Contact Us

Advertise on this Site