Vulvar condyloma acuminatum is a benign sexually transmitted lesion caused by the wart virus, occurring at the junction of the skin and mucous membranes. Vulvar inflammation, prolonged irritation by secretions, and the loosening of vulvar tissues during pregnancy all contribute to the development of this condition. It is commonly seen in patients with gonorrhea, caused by the irritation of gonorrheal pus rather than by the gonococcus itself.

bubble_chart Clinical Manifestations

The labia minora, perineum, and areas around the anus are common sites of occurrence and can spread to surrounding areas. Initially, several tiny, pale red papules appear, gradually increasing in size and number, tending to merge or overlap, forming irregularly sized papillary, mushroom-like, or cockscomb-shaped protrusions. They are soft in texture, dark red or dirty gray, with a moist, eroded surface that may secrete cloudy serous fluid or pus. At the onset, there are usually no noticeable symptoms, but as they grow, itching and a sense of pressure may occur. Condyloma acuminatum may occasionally undergo malignant transformation.

bubble_chart Diagnosis

Condyloma acuminatum should be differentiated from condyloma latum—intermediate stage [second stage] syphilis rash. The latter is often accompanied by other syphilis symptoms, with flat lesions, and Treponema pallidum can be detected in the affected area. The syphilis serological test is strongly positive. Diagnosis is not difficult based on clinical manifestations. If necessary, a biopsy should be performed to rule out cancer.

The histological structure of condyloma acuminatum appears as tree-branch-like projections, covered with squamous epithelium, with a slightly thickened stratum corneum mostly composed of parakeratotic cells. The stratum spinosum is significantly thickened and edematous. There is chronic inflammatory cell infiltration in the dermis.

bubble_chart Treatment Measures

Primarily for local treatment. Based on the disease cause that induces the growth of condyloma, actively treat vulvitis, vaginitis, and cervicitis. Pay attention to vulvar hygiene, keeping it clean and dry.

1. Use a 1:5000 potassium permanganate solution or 2-4% boric acid solution for sitz baths, once or twice daily.
2. Small lesions can be treated with phenol, trichloroacetic acid, resorcinol, or 20-25% podophyllin for cauterization, applied every 5-7 days. Care should be taken to protect the surrounding skin when applying.
3. Larger or multiple condylomas can be excised by electrocautery under local anesthesia.