Human papillomavirus physical examination
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Physical examination findings depends on the anatomic region of involvement. The cutaneous lesions are warts and mostly presents as exophytic papules on fingers and lateral surface of the hands. Intraepithelial neoplasia is the most important type of genital involvement and in suspected women, the entire genitalia must be inspected by speculum with acetic acid application in order to find the lesions. Condylomata acuminata is another type of anogenital involvement which presents as a sessile or pedunculated lesion in anogenital area. Respiratory tract may be involved during neonatal passage through birth canal and manifests as stridor and even respiratory distress.
Digital palpation of the vagina to assess for thickening or irregularity of the vaginal wall and a thorough colposcopic assessment of the entire vagina must be perform, however physical examination of patients with early stage is usually unremarkable, but after the insertion of a speculum and the application of acetic acid, lesions will appear as raised or flat white, granular epithelium with sharply demarcated borders and may contain areas of vascular punctation.
Its shape ranges from smooth flattened papule to a verrucous, papilliform appearance, may be skin-colored, brown or whitish, may also present as pedunculated or broad-based papillomas up to several centimeters in diameter or as large confluent plaques. Female and male genital area and perianal may be affected.
Other mucosal surfaces
Recurrent respiratory papillomatosis
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