HPV Lesions

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍painfulpainless genital ‍wartslesions

Location is on ‍pubispenisscrotumvulvavaginaperineumanus

Symptoms include:

‍pain

‍blisters

‍sores

‍burning

‍itching

‍tingling

‍dysuria

‍vaginal discharge, ‍clear, ‍thin, ‍withwithout fishy odor

‍urethral discharge



Contributing factors:

‍unprotected sex

‍multiple sexual partners

no history of: ‍genital warts, ‍HPV, ‍genital herpes, ‍sexually transmitted infections, ‍HIV, ‍immunodeficiency

HPV vaccination: ‍up-to-dateincompleteunvaccinated





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍

Anorectal: DRE ‍normal, prostate ‍normal, ‍blood, ‍mass, anus ‍

Pelvic: external genitalia ‍normal, vagina ‍normal, cervix ‍normal, uterus ‍normal, adnexa ‍normal, ‍cervical motion tenderness

Genital: penis ‍normal, testes and epididymis ‍normal, ‍inguinal hernia





ASSESSMENT:

‍Genital warts ‍likelysuspectedpossible

DDx: genital warts, molluscum contagiosum, genital herpes, syphilis, chancroid, lymphogranuloma venereum, granuloma inguinale, yeast infection, bacterial vaginosis, trichomoniasis, scabies, pubic lice, folliculitis, skin tags, hemorroids, contact dermatitis, psoriasis, lichen planus, lichen sclerosus, squamous cell carcinoma





PLAN:

Investigations:

- Pap smear

Treatments:

- ‍Topical treatments

- ‍Physical treatments

- ‍Intralesional treatments

- Use of condoms until warts are completely treated (but may still be transmitted)

- ‍HPV vaccine

Further care:

- Referral to dermatologist

- Referral to gynecologist

- Referral to urologist

- Follow-up in ‍ ‍weeksmonths

- Return if warts do not resolve or if new warts develop