V.D., a 49 year old, male, married and a junior executive in a reputable bank, consulted due to skin colored papules and plaques. One year prior to consultation, the patient noted skin colored papules on the perianal area not associated with pruritus or pain. The said papules gradually increased in size and the appearance of several new papules was noted with in the area. 5 months prior to consultation, some papules were noted to coalesce forming plaques, increasing in number and extending even to the perineal area. The papules and plaques were not associated with pruritus. The patient used Lactacyd for washing the affected area and self medicated with a number of unrecalled topical but the lesions persisted. He is a sexually active person, with a wife of 15 years and a steady boyfriend for 7 years prior to marriage. He experienced sexual contact with multiple partners for 5 years prior to marriage. The patient's wife has had no knowledge of his premarital and extramarital sexual activities The physical examination centered on the skin, which exhibited multiple skin, colored hyperpigmented, flat-topped papules and plaques on the perianal and perineal area. Upon medical consultation the impression of CondylomaAcuminata affecting the perianal

 

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