PRESENTED BY :

SHABRI NA
FI RDA NUR I SLAMI

SUPERVI SOR:
VELLA
CONDYLOMA ACUMINATA
Introduction
Condyloma acuminata is a papillary growth infection
lesion that is characteristically located in the
anogenital region but may also involve the oral
mucosa.
The cause of Candyloma Acuminata is Human
Papilloma Virus (HPV)
Case Report
Name : Mrs. N
Sex : Female
Reg. number : 00-16-57
Age : 40 years old
Address : Ds. Lagang
Occupation : Housewife
Exam. Date : May, 7th 2014

Case Report
The Chief Complaint:
Papuls at the perineum since 4 months ago.
History of Present Illness:
Patient visited the polyclinic with chief complaint papuls
at the perineum since 4 months ago. The lesions have no
pain but she complaint that sometimes the lesions shows
some itchy sensation. The papuls were getting bigger
since they first appeared at 4 months ago.
History of Previous Illness:
The patient admitted she had never felt like this
condition before. Diabetes mellitus disease denied.

Case Report
History of Family Disease:
None of her family had the same disease or complaint like her.
History of Treatment:
No treatment had been taken so far.
History of Social Habits:
She is a married woman without any divorce history. She had been
married since 1993 and given 5 kids so far. Her husband is a newspaper
seller. She admitted that her sexual intercourse frequency with her
husband was much less since one last year (less than once a month of
sexual intercourse). She denied about any sexual affair with some other
guy. History of sexual intercourse with her husband after she got
symptom was positive.
Case Report
Region: Perineum
Three papuls with
irregular surface. First
papul has diameter 5
mm. Second is 3 mm
and the third was 1 mm.
Region: Introitus vagina
One papul with irregular
surface


Case Report
Differential Diagnose
Condyloma Acuminata
Condyloma Lata
Squamosa cell carcinoma
Bowenoid Papulosis
Molluscum Contagiosum

Case Report
Planing Diagnostic
Acetic Acid 5%
Histologic examination
PCR techniques

Diagnose:
Condyloma Acuminata
Case Report
Treatment:
Excision with electrocautery/
Electrodesiccasion

Education:
Female clients with genital warts should have a Pap
smear at least once a year.
Clients with genital warts should be made aware that
they are infectious to sexual partners.
The regular use of condoms is recommended to help
reduce transmission.

Case Report
Prognosis
Quo ad Vitam : Dubia ad bonam
Quo ad Functionam : Dubia ad bonam
Quo ad Sanactionam : Dubia ad bonam

Discussion
Definition of Candyloma Acuminata
Condyloma acuminatum is a verrucous or papillary
growth infection lesion that is characteristically
located in the anogenital region but may also
involve the oral mucosa caused by infection with
papilloma viruses (PVs)

Discussion:
Epidemiology
Theory Case
Prevalence of
Condyloma
Acuminata is similar
between men and
women.
Frequency 1% in the
sexually active
population.

In our case, the
patient is a married
woman. She was
included to sexually
active population
Discussion: Etiology
Theory Case
Condyloma Acuminata was
caused by HPV serotypes 6,
11, 16, 18, 26-32, 39-44, 53-55,
58, 59, 64, 67. (Approx 90% of
case related to HPV types 6
and 11)

Lesions chance to be
neoplastic state
Least potent : HPV 6, 11
Moderate potent: HPV 33,
35, 39, 40, 43, 45, 51-56, 58
High potent: HPV 16, 18
In our case, we need to do
PCR examination to be able to
identify the type of the HPV
that infected the patient. Since
this examination needs a
quite much cost and time, we
didnt do the PCR
examination.
Discussion: Pathogenesis
Theory Case
History of patient with
condyloma may include
recent change in sexual
partner, partner
symptoms of STIs,
multiple partner, lack of
STI protection (lack of
condom use).
In this case, patient is a
married woman without
any divorce history and
she admitted that she
never have a sexual
contact with other guys
except her husband.

Discussion: Manifestation Clinic
Theory Case
The most commonly
affected areas are the
penis, vulva, vagina,
cervix, perineum, and
perianal area.
Uncommon mucosal
lesions in the
oropharynx, larynx, and
trachea have been
reported.

In our case, the patient
showed warts in two
location. Three papuls in
the perineum area and
one papul inside the
introitus vagina.

Differential Diagnose
Disease Lesion
Morphology
Diagnostic
Test
Etiology
Condyloma
Acuminata
Papuls with
verrucous surface
Acetic Acid
test
Human
Papilloma
Virus
Condyloma
Lata
Cutaneous
eruption,
nonpruritic, patchy
alopecia
Serologic
test
Form of
secondary
syphillis
(T Palidum )
Squamosa Cell
Carcinoma
Ulcer form. 70%
lesions are in the
head and neck
Biopsy;
comparison of
affected skin
and normal
skin
Carcinogen
s exposure
Bowenoid
Papulosis
Pigmented
papules
Acetic Acid
Test
Human
Papilloma
Virus
Molluscum
Contagiosum
Papul regular
surface with delle
PCR Pox Virus
Discussion:
Diagnostic Examination
Theory Case
Acetic Acid Test : The
procedure is performed by
soaking the external genitalia
(in men) and the vagina and
cervix (in women) with 35%
acetic acid for up to 10 min.
Genital warts turn white
(aceto whitening +)
Histopatologic
PCR: Identifying the DNA of
HPV

In our case, we can not
do the acetic acid
examination into this
patients because the test
preparation was not
available in our
polyclinic.
Discussion: Treatment
Theory Case
Surgical excision may
be performed by
cryosurgery, scalpel,
electro desiccation, or
laser ablation.
Topical: Podophyllin, 5-
fluorouracil, bleomycin,
cidofovir


In our case, we choose to
do the electrocauter
because it gives higher
effectivity to eradicate
the infected cells by HPV
and gives less recurrence
infection. But currently,
the patient has not come
yet to the polyclinic.

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