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Clinical features

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The lesions are usually asymptomatic, but depending on the size and site, genital warts can be painful, friable, or pruritic (1).

Men with genital warts generally see them. They may bleed if in the urethral meatus and be a cause of haematuria. Women generally become aware of genital warts after feeling an itch and then noticing a lump.

The lesions can be solitary or multiple. Those on the warm, moist, non-hair bearing areas are usually soft and non-keratinised. Those on the dry hairy skin are firm and keratinised (2).

Warts start as small flat lesions 1-2 mm in diameter. Their appearance resembles that of skin warts but usually remain flat. In moist, warm areas they are filiform and larger (1-5 mm). The larger warts become pedunculated and may resemble a cauliflower in appearance. The growth of the warts is favoured by pregnancy, poor hygiene and vaginal discharge.

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