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Genital warts are caused by human papillomavirus (HPV). Typical eruptions are flesh-colored with a cauliflower-like appearance, but they may also be flat, sessile, or pedunculated. They can develop anywhere in the anogenital area. Although usually asymptomatic, they may be pruritic. They range in size from a few millimeters to several centimeters.
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Management and Disposition
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Genital warts typically do not require emergent treatment, and patients may be referred for outpatient follow-up. Almost half of lesions will resolve without treatment, usually over the course of several months. Topical caustic agents can be prescribed if treatment is initiated in the emergency department. Options include imiquimod cream (applied three times weekly for up to 16 weeks), podophyllotoxin (applied twice daily for 3 days followed by no therapy for 4 days; repeat cycle up to four times), and sinecatechins (applied three times daily for up to 16 weeks).
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Advise patients that recurrence is common and multiple treatments may be needed to completely eradicate the warts. ...