Anal and Venereal warts

Anal Warts (Condyloma)
Venereal warts are sexually transmitted diseases that infect the anal and genital areas. They usually spread from person to person by sexual contact. They can also spread from inanimate objects, such as a shared bath towel. Approximately two-thirds of people who have sexual contact with a partner with genital warts will develop warts, usually within three months of contact. Scientists estimate that as many as 1 million new cases of anal and genital warts are diagnosed in the United States each year. There are two types of venereal warts, condyloma accuminatum and condyloma latum.

Condyloma Latum

Condyloma latum are reddish, moist warts, and are a sign of secondary syphilis. These warts are treated by treating the underlying syphilis infection with antibiotic.

Condyloma Accuminatum

Condyloma accuminatum are pink to whitish growths that occur on the anus and genitalia as a result of infection with the papilloma virus. The Human Papilloma Virus (HPV) is one of the most common viral sexually transmitted diseases (STD) in the United States today. As many as one in five American adults has a genital HPV infection. They occur on the penis, the vagina, the anus, and rarely, the mouth. In the anal area they may be mistaken for hemorrhoids. They are spread by contact with the wart, which actively sheds viral particles. They grow geometrically and may become extensive. (Warts on other parts of the body, such as the hands, are caused by different types of HPV. Contact with these warts does not seem to cause genital warts.)

Treatments are directed as destruction of the wart tissue to allow for normal healing. Some work has been done with immunotherapy and a commercial preparation of alpha interferon is available. The alpha interferon is injected into the wart which stimulates an immune response causing the wart to disappear. The problem with the therapy is the alpha interferon is quite expensive and doesn't work in all cases. Imiquimod cream is a self-applied immune response modifier that induces local production of interferon in patients with external genital warts.

Though genital warts can be treated, none of the available treatments are a cure for HPV. The virus can remain in nearby skin after treatment. Because the virus can lie dormant in the cells, in some cases warts can return months or even years after treatment. In other cases, warts never recur.

More reliable is wart destruction. This may be accomplished chemically with an acid compound, liquid nitrogen, or with surgery. The acid compounds are chemical cauterants which burn off the wart. Cryotherapy, or the application of liquid nitrogen to the wart tissue destroys it by freezing it. Warts may also be destroyed by electrocautery or vaporization with a CO2 laser. This is done as an outpatient at a hospital or a outpatient surgical facility. Even with surgical destruction of all warts the patient must still be carefully followed for the development of recurrence. At the time of surgery all visible warts are destroyed but it may take up to 30 days before infected tissue shows signs of wart development. It is therefore very important that prolonged follow-up be performed to assure cure.

Photo References
1. Picture: Condyloma Accuminatum - Dr. E. Brender
http://home.talkcity.com/SupportSt/drbrender/Butt_Doctor/Venereal_Warts.php

2. Picture: Condyloma Latum - Dr. J. Bezzant
http://www-medlib.med.utah.edu/kw/derm/pages/pa04_4.php