Assessment of genital warts
Genital warts are diagnosed on clinical appearance. Consider biopsy for atypical lesions (eg variable pigmentation, raised plaque-like lesions or cervical warts) to exclude cancer. Human papillomavirus (HPV) nucleic acid amplification testing (NAAT) (eg polymerase chain reaction [PCR]) is not used for genital wart diagnosisOng, 2023.
Genital warts are uncommon in populations that have been vaccinated against human papillomavirus; consider alternative diagnoses of normal anatomical variants such as pearly penile papules, Fordyce spots, Tyson glands or vestibular papillae1.
Perform investigations for other sexually transmissible infections (STIs) (including HIV, syphilis, Neisseria gonorrhoeae and Chlamydia trachomatis) in patients with suspected genital warts.
The period of infectivity and latency of HPV is not known, so it may not be possible to determine which sexual contact the virus was acquired from. Contact tracing is not usually required, but recommend HPV vaccination to sexual partners who are not fully vaccinated; see Australian Immunisation Handbook.