The management of anal warts

In the United Kingdom it is the most common sexually transmitted disease; in 1997 over 50 000 new cases were reported, accounting for 22% of all diagnoses made in genitourinary medicine clinics. 1 In the United States an estimated 1% of adults who are sexually active have lesions. 2 These benign warts are caused by human papillomavirus; genotypes 6 and 11 are found in over 90% of cases. 3 However, some patients are concurrently infected with oncogenic types of the virus, principally genotypes 16 and 18, which may induce multifocal anogenital intraepithelial neoplasia and cervical cancer. 4 Although people with anogenital warts present to many different disciplines guidelines for management have recently been published by the Medical Society for the Study of Venereal Diseases of the United Kingdom and the European Course on Human Papilloma Virus Associated Pathology Group. 5 6 These guidelines conform to recommendations as for a Cochrane review and focus on sharing management between specialists and primary care physicians. 7 No specific treatment and no one therapeutic recipe is appropriate for all patients.