[Treatment of genital Papillomavirus lesions]

Genital Papillomavirus infection has now reached epidemic size. Several techniques may be used to treat genital condylomas, but none of them is 100 percent effective. At the first consultation for external genital condylomas, the choice of treatment is determined by the size, location, number and histology of the lesions. Typical condyloma acuminata that are present in small number and have a less than 5 mm base of implantation are treated by cryotherapy or trichloracetic acid. Podophyllin should be reserved for patients with diffuse lesions. When one or several lesions do not regress after 3 to 4 weeks of treatment, surgical procedures (electrocautery, CO2 laser) must preferably be used. Condylomas that have a base of implantation wider than 5 mm are directly destroyed by surgical excision, as are dysplastic lesions. Post-treatment cure of external genital lesions must be confirmed by a negative acetic acid test. Patients should be advised to utilize condoms throughout the duration of treatment.