Anal warts (condylomata acuminata) - current issues and treatment modalities.

HPV infections are currently the most frequent cause of genital infections in the USA. Risk factors are early onset of sexual activity, multiple sexual partners, a history STDs, an early age of first pregnancy and tobacco use. In the past, HPV viruses were thought to be STDs, but it is now known that penetration is not necessary. Skin-to-skin or mucosa-to-mucosa contact is enough to transmit the virus, which presents high tropism for those tissues. The Papillomaviridae family includes over 120 viruses, some of which have high malignant transformation rates. The most common malignancy connected to HPV is uterine cervix cancer and anal canal cancer. The range of morphology of perianal lesions means that a thorough clinical examination is required, including an anoscopy. Therapeutic modalities often seek to eliminate macroscopic changes rather than focus on the cause of the infection, which leads to a high recurrence rate. Externally located changes can be eliminated with patient-applied treatments. Those located in the anal canal and distal end of the rectal ampulla require treatment by a qualified medical provider. Due to the high recurrence rate after standard treatment, special attention has been given to vaccinations. The polyvalent vaccine includes HPV viruses with both low and high malignant transformation risk. This has led to a decrease in the rate of malignancies.