Human papillomavirus history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]


Detailed history about sexual activities and partners must be taken from every patient with anogenital involvement. Symptoms are mostly related to skin irritation and mucosal surface involvement.


A detailed and thorough history from the patient is necessary. Specific areas of focus when obtaining a history from the patient include:[1][2]

1- Recent sexual activities
2- Number of sex partners or any new partner
3- Using condom
4- History of prior STDs
5- Sex practice
6- Number of pregnancies
7- Recent close contact with persons having cutaneous wart


Cutaneous lesions

The hallmark of cutaneous involvement is pruritus, however, the majority of the people acquiring HPV are asymptomatic. The clinical manifestation of HPV infection is wart that sometimes might be painful.[3]

Anogenital lesions

Intraepithelial neoplasia (squamous cell carcinoma)

These lesions are mostly asymptomatic although, may cause postcoital spotting or vaginal discharge. When it progress to squamous cell carcinoma, the presenting symptoms would be abnormal vaginal bleeding, pelvic pain and painful intercourse.[1]

Condylomata acuminata

They are often asymptomatic but may cause pruritus, bleeding, burning, tenderness, vaginal discharge and pain. Large exophytic lesions may interfere with defecation, intercourse or even delivery.[1]

Other mucosal involvement

Recurrent respiratory papillomatosis

Present with hoarseness or in infants, with an altered cry. Sometimes, leads to respiratory distress and stridor.[4]

Conjunctival papillomas

Present with redness, itching, foreign body sensation and tearing in the affected eye.[5][6]


  1. 1.0 1.1 1.2 Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
  2. Ho GY, Bierman R, Beardsley L, Chang CJ, Burk RD (1998). "Natural history of cervicovaginal papillomavirus infection in young women". N. Engl. J. Med. 338 (7): 423–8. doi:10.1056/NEJM199802123380703. PMID 9459645.
  3. Jablonska S, Orth G, Obalek S, Croissant O (1985). "Cutaneous warts. Clinical, histologic, and virologic correlations". Clin. Dermatol. 3 (4): 71–82. PMID 2850861.
  4. Venkatesan NN, Pine HS, Underbrink MP (2012). "Recurrent respiratory papillomatosis". Otolaryngol. Clin. North Am. 45 (3): 671–94, viii–ix. doi:10.1016/j.otc.2012.03.006. PMC 3682415. PMID 22588043.
  5. Mlakar J, Kocjan BJ, Hošnjak L, Pižem J, Beltram M, Gale N, Drnovšek-Olup B, Poljak M (2015). "Morphological characteristics of conjunctival squamous papillomas in relation to human papillomavirus infection". Br J Ophthalmol. 99 (3): 431–6. doi:10.1136/bjophthalmol-2014-306087. PMID 25527693.
  6. Sjö NC, von Buchwald C, Cassonnet P, Norrild B, Prause JU, Vinding T, Heegaard S (2007). "Human papillomavirus in normal conjunctival tissue and in conjunctival papilloma: types and frequencies in a large series". Br J Ophthalmol. 91 (8): 1014–5. doi:10.1136/bjo.2006.108811. PMC 1954828. PMID 17166894.

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