Which is most commonly implicated in genital (vulval) warts?
Ans. is d, i.e. HPV 6Ref: Williams Gynae 1st/ed, p619"Low Risk HPV types 6 and 11 cause nearly all genital warts." - Williams Gynae 1st/ed, p67Genital Warts:* Genital warts are lesions created from productive infection with HPV (most common type 6 and 11).* They display various morphologies and appearances ranging from flat papules to the classic verrucous, polyphytic lesions, termed "condyloma acuminata".* Sites: External genital warts may develop at sites in the lower reproductive tract, urethra, anus, or mouth.* Diagnosis: They are typically diagnosed by clinical infection, and biopsy is not required unless co-existing neoplasia is suspected. HPV serotyping is not required for routine diagnosis.Treatment:* Condyloma acuminata may remain unchanged or resolve spontaneously.* Effect of treatment on future viral transmission is unclear. However, many women prefer removal, and lesions can be destroyed with sharp or electrosurgical excision, cryotherapy, or laser ablation. In addition, very large, bulky lesions may be managed with cavitational ultrasonic surgical aspiration.Medical Management of Genital Warts:* Topical 5-percent imiquimod cream (immunomodulator)* Podophyllin (antimitotic agent)* Trichloroacetic acid (proteolytic agent)* Bichloroacetic acid (proteolytic agent)* Intralesion injection of interferonNote: Intralesion injection of interferon has high cost, is painful and is inconvenient to administer, So this therapy is not recommended as a primary modality and is best reserved for recalcitrant cases.Therapy of choice: No data suggest the superiority of one treatment. Thus in general treatment should be selected based on clinical circumstances and patient and provider preferences.
HPV 16
HPV 18
HPV 31
HPV 6
Carcinoma Cervix