From the Guidelines
Patients with genital papilloma in the penile and pubic area should be referred to a dermatologist or a urologist, as both specialties can provide appropriate treatment and management. The choice between dermatology and urology depends on the specific location and extent of the warts, as well as the patient's overall health and preferences.
- For warts located on the skin of the penis and pubic area, a dermatologist may be the best choice, as they specialize in the treatment of skin conditions.
- For warts located on the urethra or other genital areas, a urologist may be more appropriate, as they specialize in the treatment of urinary tract and genital disorders. Treatment options for genital papilloma include patient-applied therapies, such as imiquimod 3.75% or 5% cream, or podofilox 0.5% solution/gel, as well as provider-administered therapies, such as cryotherapy with liquid nitrogen, trichloroacetic acid (TCA) 80-90% applied weekly, surgical excision, or electrocautery 1. The treatment choice depends on the number, size, and location of the warts, as well as the patient's preference, cost, and provider experience. It is essential to note that no single treatment eliminates all warts or prevents recurrence in all patients, and patients should avoid sexual contact with the treated areas until healed, and use condoms to reduce transmission risk 1. Treatment aims to remove visible warts rather than eliminate HPV infection, as the virus may persist in surrounding tissue even after wart clearance. In terms of prevention, the HPV vaccine is recommended for individuals aged 9-45 years to prevent HPV-related diseases, including genital warts and cervical cancer 1. Overall, a multidisciplinary approach, involving both dermatology and urology, may be necessary to provide comprehensive care for patients with genital papilloma.
From the FDA Drug Label
Imiquimod Cream should be applied 3 times per week to external genital/perianal warts. Imiquimod Cream treatment should continue until there is total clearance of the genital/perianal warts or for a maximum of 16 weeks.
Tratamiento para papiloma genital: El tratamiento para papiloma genital en el área del pene y la zona púbica es con Imiquimod Cream, que se aplica 3 veces a la semana hasta que desaparezcan las verrugas genitales o durante un máximo de 16 semanas. Especialidad médica: La especialidad médica que se debería consultar es Dermatología, ya que el tratamiento se aplica directamente en la piel. 2 2
From the Research
Specialties for Genital Papilloma Treatment
For a patient with genital papilloma in the penile and pubic area, the recommended specialties to consult are:
- Urology: for issues related to the urinary tract and male reproductive system, including the penis 3
- Dermatology: for skin-related issues, including genital warts and papilloma in the pubic area 4, 5
Treatment Options
Treatment options for genital papilloma may include:
- Topical imiquimod cream: which has been shown to be effective in treating genital warts and papilloma 6, 7
- Podofilox 0.5% solution: a patient-administered therapy that is effective in treating genital warts 4
- Carbon dioxide laser therapy, surgery, and electrosurgery: which are effective for wart removal at the end of treatment 4
- Vaccination: which is the primary method of prevention for human papillomavirus (HPV) infection, the cause of genital papilloma 3
Diagnosis and Referral
Diagnosis of genital papilloma is typically made clinically by the appearance of single or multiple lesions, and may be referred to a specialist such as a urologist or dermatologist for further evaluation and treatment 4, 5