HPV Infection: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin, mucous membranes and oral cavity.
      • Genital region [Symptoms: Bowenoid papulosis – skin infection with human papillomavirus (HPV) in the genital area, which leads to characteristic papular skin lesions; condylomata acuminata (synonym: genital warts)]If necessary, acetic acid test: suspicious lesions of the skin (eg, penile trunk, vagina) are wetted with (3-) 5% acetic acid; after a few minutes appearing white color indicates HPV-induced skin lesions.
      • Anal region [due todifferential diagnoses: hemorrhoids; mariscae – skin folds at the anus, which usually remain after perianal thrombosis; due topossible sequelae: Anal carcinoma (anal cancer)]Note: Anal marginal carcinoma is often a visual diagnosis!
    • Palpation (palpation) of the inguinal lymph nodes [if necessary positive for anal carcinoma / anal cancer: inguinal lymph nodes belong to the first lymph node station of anal carcinomas].
    • Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation [due toanal carcinoma].
  • Dermatological examination [due todifferential diagnoses:
    • Malignant tumors, unspecified
    • Condylomata lata in syphilis – sexually transmitted disease.
    • Erythroplasia Queyrat – shiny or erosive skin lesions, occurring mainly on the genital organs, which is considered precancerous (precancerous).
    • Fibromas – benign skin tumors
    • Melanoma – black skin cancer
    • Mollusca contagiosa (dell warts)
    • Bowen’s disease – precancerous (precancerous) squamous cell carcinoma of the skin; clinical picture: single sharply demarcated but irregularly shaped, broad red-scaly skin lesions erythrosquamous or psoriasiform plaques (size varies from millimeters to decimeters); skin lesions are similar to psoriasis (psoriasis), but usually occurs only a single focus.
    • Nevi (moles)
    • Verrucous carcinoma – wart-like malignant tumor; due topossible sequelae: malignant degeneration of skin lesions]
  • Cancer screening
  • ENT medical examination [due topossible secondary diseases:
    • Larynxpapillomatosis
    • Oral cavity carcinoma
    • Oropharyngeal carcinoma (oral pharyngeal cancer); about 80% is HPV-associated]
  • Gynecological examination [due topossible secondary disease:
    • Cervical carcinoma (cervical cancer).
    • Vulvar carcinoma (vulvar cancer; cancer of the female external genital organs)]
    • Subclinical genital condyloma (Condylomata acuminata) and intraepithelial neoplasia (dysplasia considered precancerous) can be visualized by acetic acid test (dabbing the lesion with 3-5% acetic acid).
  • Urological examination [due topossible secondary diseases: penile carcinoma (penile cancer)]

Square brackets [ ] indicate possible pathological (pathological) physical findings.