Syphilitic condylomata lata mimicking anogenital warts

BRUINS, FRANK G.; Deudekom, F J A van; Vries, Henry J. C. de

doi:10.1136/bmj.h1259

Cited by 13 publications

(11 citation statements)

References 4 publications

(1 reference statement)

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“…In secondary syphilis, re-manifestation of the disease, often at 3–5 months, can lead to the development of perianal condylomata lata and perianal mucocutaneous lesions [ 6 , 7 ]. Condylomata lata are papules ‘with a moist, cauliflower-like or velvety surface’ arising in skinfolds, inguinal, perianal and peri-vaginal regions [ 8 ]. These lesions act as a reservoir for treponemes.…”

Section: Discussionmentioning

confidence: 99%

“…However, unlike in chronic primary fissure-in-ano there should be no preponderance for the posterior commissure of the anal canal. The more protuberant, cauliflower-like, condylomata lata may be mistaken for anal cancers or warts [ 8 , 9 ]. The perianal manifestations of secondary syphilis are likely to be accompanied by constitutional symptoms of the spirochetaemia including generalized rash, lymphadenopathy, fevers etc.…”

Section: Discussionmentioning

confidence: 99%

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Syphilis as an atypical cause of perianal fissure

Cox

Rao

2018

Journal of Surgical Case Reports

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We present the case of a 29-year-old woman who attended a surgical outpatient clinic with symptoms of perianal fissure due to syphilitic infection. This uncommon aetiology of a common condition is often alluded to in textbooks, but little information exists in the scientific literature regarding the pathogenesis, presentation and treatment of fissure-in-ano secondary to syphilis. We present the case and an overview of the topic aimed at surgeons and clinicians who manage patients with perianal pathology. Syphilis is far from a disease of antiquity; in patients presenting with fissure-in-ano a thorough sexual history and sexually transmissible infection screening in at-risk groups may avoid mis-diagnosis, community transmission and unnecessary procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Syphilis as an atypical cause of perianal fissure

Cox

Rao

2018

Journal of Surgical Case Reports

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“…While condylomata lata represent a well-known type of syphilids, they frequently occur in patches and are characterized by a verrucous surface and a broad base [ 7 ] . Not infrequently, condylomata lata are mistaken for condylomata acuminata, which are caused by human papillomaviruses (HPV) [ 8 ] . Common prodromes in early syphilis include general symptoms such as fever, headache, fatigue, myalgia, and arthralgia.…”

Section: Discussionmentioning

confidence: 99%

Soft, slightly tender perianal nodules

Wiskemann¹,

Durani²,

Kohl

et al. 2017

J Deutsche Derma Gesell

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“…Condylomata lata or condyloma latum are cutaneous lesions of secondary syphilis caused by the spirochete, Treponema pallidum 34,35. Clinically, condylomata lata manifest as moist, gray-white, velvety, flat-topped or cauliflower-like, broad papules or plaques 36. They tend to develop in warm, moist sites of the genitals and perineum 36.…”

Section: Diagnosismentioning

confidence: 99%

“…Clinically, condylomata lata manifest as moist, gray-white, velvety, flat-topped or cauliflower-like, broad papules or plaques 36. They tend to develop in warm, moist sites of the genitals and perineum 36. A nonpruritic, diffuse, symmetrical, maculopapular rash on the trunk, palms, and soles is characteristic of secondary syphilis 34.…”

Section: Diagnosismentioning

confidence: 99%

Penile warts: an update on their evaluation and management

Leung¹,

Barankin²,

Leong³

et al. 2018

DIC

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BackgroundPenile warts are the most common sexually transmitted disease in males. Clinicians should be familiar with the proper evaluation and management of this common condition.ObjectiveTo provide an update on the current understanding, evaluation, and management of penile warts.MethodsA PubMed search was completed in Clinical Queries using the key terms ‘penile warts’ and ‘genital warts’. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews.ResultsPenile warts are caused by human papillomavirus (HPV), notably HPV-6 and HPV-11. Penile warts typically present as asymptomatic papules or plaques. Lesions may be filiform, exophytic, papillomatous, verrucous, hyperkeratotic, cerebriform, fungating, or cauliflower-like. Approximately one-third of penile warts regress without treatment and the average duration prior to resolution is approximately 9 months. Active treatment is preferable to watchful observation to speed up clearance of the lesions and to assuage fears of transmission and autoinoculation. Patient-administered therapies include podofilox (0.5%) solution or gel, imiquimod 3.75 or 5% cream, and sinecatechins (polypheron E) 15% ointment. Clinician-administered therapies include podophyllin, cryotherapy, bichloroacetic or trichloroacetic acid, oral cimetidine, surgical excision, electrocautery, and carbon dioxide laser therapy. Patients who do not respond to first-line treatments may respond to other therapies or a combination of treatment modalities. Second-line therapies include topical/intralesional/intravenous cidofovir, topical 5-fluorouracil, and topical ingenol mebutate.ConclusionNo single treatment has been shown to be consistently superior to other treatment modalities. The choice of the treatment method should depend on the physician’s comfort level with the various treatment options, the patient’s preference and tolerability of treatment, and the number and severity of lesions. The comparative efficacy, ease of administration, adverse effects, cost, and availability of the treatment modality should also be taken into consideration.

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Syphilitic condylomata lata mimicking anogenital warts

Cited by 13 publications

References 4 publications

Syphilis as an atypical cause of perianal fissure

Syphilis as an atypical cause of perianal fissure

Soft, slightly tender perianal nodules

Penile warts: an update on their evaluation and management

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