Condylomas: what they are and how to treat them

By Cristiano Antonino On Nov 26, 2022

Condylomas are benign tumour lesions, mainly transmitted sexually, and caused by viruses of the papillomavirus type

How widespread are condylomas?

It has been observed in studies that the disease frequently affects immunocompromised individuals, including those who have had contact with the Acquired Immunodeficiency Virus (AIDS), with an estimated frequency ranging from 60 to 80% of cases. Homosexuals are more affected.

Mode of contagion

Sexual contact is the main mode of transmission.

The partner should also be checked and treated at the same time.

Lesions tend to spread rapidly and increase in size.

In clinical practice, individuals are observed to have developed the disease after stays in non-EU countries, following casual sexual intercourse.

How do condylomas present themselves?

The lesions appear as small exophytic, warty, whitish, pedunculated vegetations.

They affect the perianal area, the anal canal and sometimes in association or in isolation the genitals.

If they persist for a long time there is the rare possibility of tumour degeneration.

Condylomas, the diagnosis

The clinical appearance is typical and sufficient to make the diagnosis.

If the lesions date back a long time and swellings are present, a tissue sample for histological examination is indispensable.

A serological and immunological study to assess possible viral contacts and to clarify the antibody defence status may be indicated.

These investigations are not considered mandatory but precautionary, before proceeding to treatment.

Therapy

Various treatments are used, on the understanding that spontaneous healing does not normally occur and, depending on the characteristic of evolution, it is correct to initiate the planned therapies even in the presence of minimal lesions.

The main treatments are listed below:

Local application of Podophyllin (anti-cancer agent)
Cryotherapy (cold) with liquid nitrogen
Local removal with scalpel or electrosurgery
Local excision with laser

Immunostimulant therapy with Interferon, for use in baseline or relapsed immunocompromised individuals, subcutaneously or intramuscularly

The decision to carry out the planned therapies must be evaluated in relation to the site and number of lesions.

Close collaboration between the colon proctologist and the dermatologist with specific experience in the treatment of sexually transmitted diseases (STDs) would be desirable in order to define a single therapy protocol.