HPV

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HPV

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3 Posts

dimps
Forum Guru

Topics: 63
Posts: 446

01/14/05 - 03:52 PM

A 29-year-old man comes to the office because one of his 3 sexual partners recently had a Pap smear that showed dysplasia and koilocytic changes. Her physician recommended that all of her sexual partners be evaluated. He has always been healthy and has never had any sexually transmitted diseases. All of his partners are "on the pill" so they do not use condoms. Physical examination is completely unremarkable. There are no visible lesions on his anogenital region. He is still very concerned that he has an infection that you cannot see. The most appropriate next step is to

A. advise him to return if he develops any lesions

B. apply vinegar to his penis and scrotum

C. recommend that he use condoms during all sexual activity

D. send for a fluorescent treponemal antibody absorption (FTA-ABS) serology

E. take random biopsies of the penis

F. tell him that he is healthy

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doc4mindia
Forum Guru

Topics: 134
Posts: 243

01/14/05 - 04:56 PM

C. recommend that he use condoms during all sexual activity

dimps
Forum Guru

Topics: 63
Posts: 446

02/01/05 - 03:56 PM

The correct answer is B. This patient's girlfriend most likely has human papillomavirus (HPV) infection, which is associated with dysplastic changes and cervical cancer. This patient should be evaluated for an HPV infection, and if there are no visible lesions, acetic acid (vinegar) should be applied to the anogenital region to detect the presence of the virus. Invisible lesions typically turn white when acetic acid is applied. This is thought to occur because the acetic acid causes maceration and swelling of virally induced epithelial hyperplasia, which usually has an increased glycogen content and enhanced permeability. Even though this is not specific for HPV and false-positives can occur, it may enhance the detection of an HPV infection

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