History and exam

Key diagnostic factors

common

increased risk of exposure to HPV

Having intercourse from an earlier age and an increasing number of lifetime sexual partners, both of the individual and of their partner, all increase the risk of genital warts.[21][22][23][24]​​​​​​​​[25]​​

immunocompromise

A risk factor for genital warts.

Spontaneous resolution of human papillomavirus infection is less likely when defects in the cell-mediated immune response exist.[26]​​[27]​​

sessile exophytic papillomas

Lesions are usually 1 to 3 mm, discrete, sessile, smooth-surfaced exophytic papillomas or they may coalesce into larger plaques.[Figure caption and citation for the preceding image starts]: Wart on shaft of penisFrom Dr Tyring's personal collection; used with permission [Citation ends].com.bmj.content.model.Caption@2615f9db[Figure caption and citation for the preceding image starts]: Close-up of penile wartFrom Dr Tyring's personal collection; used with permission [Citation ends].com.bmj.content.model.Caption@56646dd6

Colour varies from flesh-coloured to whitish to hyperpigmented.

Maceration may be present, particularly in moist areas.[Figure caption and citation for the preceding image starts]: Venereal warts in the anal region of the perineumCDC/Dr Wiesner [Citation ends].com.bmj.content.model.Caption@1812cbcd

Other diagnostic factors

common

asymptomatic

Lesions are generally asymptomatic, and can be in an area that the patient has difficulty viewing.

uncommon

pruritus

Lesions are usually asymptomatic, but patient may present with itch.

bleeding

Usually due to local trauma or maceration of the area, depending on where the warts are located (e.g., if the warts are in the inguinal area, they can be rubbed by underwear or with walking).

pain

Occurs when the lesions become friable or become irritated from local trauma/maceration.

urinary symptoms

Symptoms such as terminal haematuria or abnormal stream of urine can indicate lesions in the distal urethra and meatus.

Risk factors

strong

intercourse at an early age

Having intercourse from an earlier age increases the likelihood of having a greater number of partners and thereby increases the risk of exposure to human papillomavirus.[21][22]

increasing number of lifetime sexual partners

An increasing number of sexual partners raises the risk of genital warts by increasing the risk of exposure to human papillomavirus.[23][24]

young sexually active adults

Females aged 19 to 22 years and males 22 to 26 years are susceptible to get infected with human papillomavirus.​[7]​

increasing number of partner's lifetime sexual partners

Collectively increases the risk of exposure to human papillomavirus.[22][25]

immunocompromise

Spontaneous resolution of human papillomavirus infection is less likely when defects in the cell-mediated immune response exist.[26][27]

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