A 30-year-old woman presents with painless, soft, flesh-coloured, cauliflower-like growths in the perianal region. On application of 5% acetic acid, the lesions turn white. PCR confirms high-risk HPV type 16. Which statement about this condition and its management is CORRECT?
- A Low-risk HPV 6/11 cause condylomata acuminata; podophyllin 10–25% should be avoided in pregnancy; imiquimod is an alternative ✓
- B High-risk HPV 16/18 causes condylomata acuminata; podophyllin is the treatment of choice for perianal warts
- C High-risk HPV 16/18 cause flat condylomata; imiquimod 5% cream is the first-line therapy
- D Low-risk HPV 6/11 cause Bowenoid papulosis; cryotherapy is contraindicated
Explanation
Condylomata acuminata (anogenital warts) are caused by low-risk HPV types 6 and 11, not HPV 16/18. High-risk types 16 and 18 are associated with cervical intraepithelial neoplasia, Bowen's disease, and Bowenoid papulosis. Podophyllin 10–25% in tincture of benzoin is a provider-applied therapy but is contraindicated in pregnancy (teratogenic) and on perianal/vaginal mucosa. Patient-applied imiquimod 5% cream (immune response modifier/TLR7 agonist) or podophyllotoxin 0.5% solution are self-applied alternatives. Perianal warts are best treated with trichloroacetic acid or physical ablation.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.