Genital warts. Newly discovered consequences of an ancient disease.

Venereal warts are an ancient disease, but the relationship between certain human papillomavirus serotypes and genital neoplasia is just being recognized. Women are at higher risk for development of neoplasia from the infection and are more likely to be reinfected, because a male partner's lesions may be invisible without application of acetic acid or examination of a urethral smear. Other factors that favor progression to cancer are young age at first exposure, multiplicity of exposures, and immunosuppression. Colposcopy with cytology and biopsy allows definitive microscopic identification of the virus and serotyping. Aggressive management of both male and female partners will reduce the spread of the virus and reinfection. Successful treatment methods have included cryosurgery; electrocautery; carbon dioxide laser therapy; and use of a keratolytic, cauterizing agent, topical fluorouracil (Efudex), and interferon.