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Genital Warts (Condyloma Acuminatum): Pathology, Signs & Symptoms

by John Fisher, MD
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    00:02 Genital warts develop in about two-thirds of sexual contacts of persons who have genital warts, so it's really highly contagious.

    00:11 And what happens is the virus enters through the skin, after some break in the skin, and gets into the basal layers of the epidermis.

    00:24 And there, the viral capsid modifies its conformation and enters the cell.

    00:31 And so, I think you can see that problems develop in an upward direction from the basal layer.

    00:39 So basal layer infected initially, and then the virus is moved to the surface with the normal proliferation of squamous epithelium.

    00:50 So the virus will replicate, and then finally release the live and infectious virions from the outermost portion of the skin, which is why it is so contagious.

    01:04 So all epidermal layers proliferate leading to something called acanthosis, which is simply hyperplasia of the squamous cell epithelium.

    01:17 Also, parakeratosis, which is keratinization of the surface cells with retention of nuclei in the stratum corneum.

    01:28 Those nuclei are not supposed to be there.

    01:31 Hyperkeratosis, which produces this thickened appearance.

    01:37 And then some cells transform into koilocytes, and what’s showing here is these vacuolated cells, which are called koilocytes.

    01:49 That’s the hallmark pathologically of a HPV infection.

    01:54 So clinically, these warts are flesh-colored to gray.

    02:00 They’re hyperkeratotic and exophytic.

    02:04 Exophytic means that they are proliferating out to the surface.

    02:10 They’re normally sessile on the skin, which means they’re flat and attached, or they can be attached by a short, broad peduncle or stalk.

    02:20 In uncircumcised men, they involve, as this picture shows, the preputial cavity 85 to 95 percent of the time.

    02:31 In the circumcised men, the penile shaft is involved.

    02:35 And among men who have sex with men, we get these warts in the anal mucosa.

    02:42 Women get this in the posterior introitus, the labia, or clitoris.

    02:48 Now, most of these warts are asymptomatic.

    02:51 But occasionally, the patient will complain of itching, burning, pain, or even tenderness, but that’s not frequent.


    About the Lecture

    The lecture Genital Warts (Condyloma Acuminatum): Pathology, Signs & Symptoms by John Fisher, MD is from the course Genital and Sexually Transmitted Infections.


    Included Quiz Questions

    1. Basal layer
    2. Granular layer
    3. Keratin layer
    4. Stratum corneum
    5. Stratum lucidum
    1. Fleshcolored hyperkeratotic sessile or broad pedunculated papules.
    2. Beefy red sessile exophytic papules.
    3. Long pedunculated p\papules that are flesh-colored and typically asymptomatic.
    4. Broad ulcers that are friable with a necrotic base.
    5. Wide spaced vesicles and pustules that are typically tender to palpation and itchy.
    1. Koilocytes
    2. Thickening of the stratum corneum
    3. Nucleated keratocytes
    4. Acanthosis nigracans
    5. Hyperkeratosis

    Author of lecture Genital Warts (Condyloma Acuminatum): Pathology, Signs & Symptoms

     John Fisher, MD

    John Fisher, MD


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    By Raneem A. on 07. January 2018 for Genital Warts (Condyloma Acuminatum): Pathology, Signs & Symptoms

    I watched most of the STD lectures. They are well explained and I really appreciate that. THANK YOU