Previous quadrivalent-HPV vaccination, especially if given before the commencement of sexual activity Distinguishing characteristics of a genital wart compared to a normal anatomical variant These images can also be used to reassure patients and educate them on the differences between normal anatomy and conditions that would require treatment. Having access to a bank of images, such as those on the Melbourne Sexual Health Centre website ( is very useful. Despite these features, it can sometimes still be difficult to be sure, especially if the appearance is atypical. Table 1 outlines some typical features that are suggestive of genital warts. Normal variants should not produce any symptoms of pain or be associated with inguinal lymphadenopathy. Most anatomical variants share characteristic features that help with recognition, such as symmetry, a smooth surface and well circumscribed border.
There are other conditions that may cause genital pathology that are not covered, and treatment is not discussed in detail.
This article aims to assist diagnosis by outlining some common anatomical variants and comparing them to a few pathological conditions. 1 With the extension of this vaccination program to young men, it is expected that the incidence of genital warts will fall further and will also decline in homosexual men: genital lumps in young adults are now less likely to be warts. Since the introduction of the National Human Papillomavirus Vaccination Program for young women in 2007, the incidence of genital warts has fallen dramatically in young Australian heterosexuals.
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