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  • Human papillomavirus (HPV) has a worldwide occurrence, affecting people of all ages and all races. It is most common in children and young adults.

  • There are more than 150 genotypes of HPV, with some regional specificity. Low-risk types cause warts; high-risk types are associated with intraepithelial neoplasia and malignancy.

  • The lesions are well-defined, raised papules or plaques with a rough or hard surface, usually without inflammation.

  • The lesions are most common on the hands or feet, but any skin site may be affected, including the lower genital or oral mucosa.

  • Treatments include destructive, antiviral, antiproliferative, and immunologic modalities.


Human papillomavirus (HPV) infections are very common, occurring in a worldwide distribution, affecting all ages and lasting months or years. The majority of individuals will have at least one infection with the virus during the course of a lifetime, although the severity and duration of the disease will depend, to a large extent, on the immune response raised against the virus-infected cells.

The clinical disease caused by the virus is also dependent on the viral genotype and the body site. Whereas skin and mucosal warts are benign and induced by one of several different types according to body site, premalignancies and invasive cancer of the anogenital area or oropharynx are associated with other, so-called high-risk, HPV types (Table 167-1).

TABLE 167-1Diseases Caused by or Associated with Human Papillomavirus Infection


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