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genital warts - rocky.ky
#1
what is the treatment of choice?
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#2
hello
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#3
There is no evidence to suggest that one treatment is significantly superior to another or appropriate for all patients and all types of warts

use one of three major approaches:

(1) Chemical agents:
- podophyllin,
- trichloroacetic acid,
- 5-fluorouracil/epinephrine gel

(2) Immune modulation:
- Imiquimod
- interferon alfa

(3) Surgery:
- cryotherapy
- laser therapy
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#4
Condyloma acuminata (anogenital warts) - pruritis, bleeding, burning, tenderness, d/c, pain. large lesions can interfere w/defecation, intercourse, and delivery. Inspection + acetic acid turning lesion white usually sufficient to make dx. Caused by HPV, mc viral STD in US. Tx. 3 ways - chemical/physical destruction, immunotx., surgical excision. Chemical best initial way, so trichloroacetic acid vs. podophyllin. TA destroys by protein coagulation, clearance rate not high, so need repeated applications. Podophyllin has similar effect, but not indicated for internal use ie. don't put on mucosal surface, and contraindicated in pregnancy.

If discover condyloma acuminata during delivery, proceed w/ vaginal delivery unless lesions are so large that they might bleed excessively. HPV can be transmitted to child during delivery in < 1%.
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#5
thanks guys
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#6
great, important topic..thanks!
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