Value of acetic acid screening for flat genital condylomata in men

Application of acetic acid solution to the genital skin followed by magnified examination permits the detection of grossly inapparent flat condylomata acuminata. To evaluate the accuracy of this screening method, the male sexual partners of 36 women with genital condylomata were examined by this method and biopsies were obtained when results were positive. Of 47 biopsies of acetowhite (the whitish change that occurs when an epithelial surface is stained with acetic acid) lesions there were 26 cases of histologically confirmed condylomata, 9 of koilocytotic atypia and 12 with false positive results. There were 25 men whose sexual partners had cervical condylomata and cervical dysplasia. In this subgroup, considered to be at higher risk for flat condylomata, the screening method revealed 15 cases of condylomata, 6 of koilocytotic atypia and 4 in which no changes by acetic acid could be found. The extensive involvement of genital skin with flat condylomata in this subgroup raises doubts as to the practicality of treatment. Nevertheless, before treatment is rendered a punch biopsy for confirmation of the screening test is advised.