Condylomata Acuminata

A 57-year-old man who had recently arrived in the United States from El Salvador presented with a nodular growth in his left naris. He reported that the lesion, which had been slowly progressing for several months, now completely blocked his left nostril. His only symptom was impaired inhalation.

The patient denied any significant past medical history or hospitalizations. He takes no medications and has no allergies. The unusual location of the lesion raised the suspicion of syphilis; results of a VDRL test were negative.

Two facial lesions were noted: the skin-colored, nodular, hyperkeratotic mass that blocked the left nostril and a small, hyperkeratotic lesion below the lower lip, which was surrounded by numerous smaller warts. Histologic examination of material from the larger lesion revealed condyloma acuminatum.

Gopi Rana-Mukkavilli, MD of New York City writes that this patient's benign wart at the nostril was excised. These lesions are caused by human papillomavirus. They are slow-growing and uniform in pigmentation. Unlike malignant lesions, warts seldom bleed or ulcerate. They may arise anywhere on the body.

Treatment options include surgical or laser excision and cryosurgery. After surgical removal of his wart, this patient was lost to follow-up.