Which type of human papillomavirus (HPV) is associated with nonmucosal, condyloma acuminatum-appearing warts found under the pannus in intertriginous areas? Is there an associated risk for cervical or oropharyngeal cancers? — Tiffany C. Coughenour, PA-C, Idaho Falls

HPV can be associated with genital and mucosal lesions or with nongenital lesions. The former are most commonly observed clinically as bowenoid papulosis, cervical intraepithelial neoplasia (CIN), cervical cancer, condyloma acuminatum, giant condyloma of Buschke and Lowenstein, laryngeal papilloma and oral papilloma; these lesions are most frequently associated with HPV types 6, 11, 16, and 18.

Nongenital (nonmucosal) lesions can present in such various settings as Bowen’s disease, common warts, epidermodysplasia verruciformis, flat warts, myrmecia warts, plantar warts and squamous cell carcinoma. Although certain HPV types are more commonly associated with each of the specific clinical lesions, many reviews do not describe the HPV type(s) associated with condyloma acuminatum-appearing warts found under the pannus in intertriginous areas (J Cutan Med Surg. 2001;5:43-60, and Int J Dermatol. 2001;40:373-379).

The risk for genital cancer is usually related to the HPV type. HPV types 6 and 11 have been associated with CIN, and HPV types 16 and 18 are more commonly observed in cervical cancer. However, some of the other HPV types that have been less frequently associated with either CIN or cervical cancer include 30, 31, 33, 35, 39, 41, 43, 45, 51, 52, 54, 56, 58, 59, 62, 66, and 67. — Philip R. Cohen, MD (154-11)