1. Condyloma acuminatum is a benign epithelial proliferation caused by human papilloma virus (HPV), especially type 6 and 11.
2. Condyloma acuminatum may involve mucocutaneous genital surfaces of either sex. Sexual contact is the most likely mode of transmission. It is most common after puberty. Its presence in prepubertal child should arouse suspicion of sexual abuse.
3. Grossly, the lesion is a sessile or pedunculated papillary excrescence. In male, it often involves the coronal sulcus or inner surface of the prepuce. Large condylomas are cauliflower-like in appearance and small ones require colposcopic detection.
4. Microscopic characteristics include branching fibrovascular stromal papillae covered by hyperplastic stratified squamous epithelium, often associated with prominent hyperkeratosis. Vacuolation of superficial epithelial cells (koilocytosis) is common. Maturation of epithelial cells is orderly, in contrast to carcinoma in situ.
5. Most lesions remain benign. They may recur due to persistence of HPV infection.
6. It has association with and possible etiologic role in the development of cervical dysplasia, carcinoma in situ, and squamous cell carcinoma. Type16, 18, and 31 have been found in the vast majority of high-grade precancerous lesions and invasive carcinomas.