OBJECTIVE--To evaluate the prevalence of "high-risk" human papilloma virus (HPV) types in penile condyloma-like lesions and to correlate HPV types with clinical and histological features. DESIGN--The study included 94 male patients with signs of penile HPV infection. From acuminate, papular and macular lesions, specimens were collected for HPV DNA hybridisation, using the dot blot and Southern blot techniques. Biopsy specimens from 51 cases were examined by light microscopy for signs of koilocytosis and dysplasia. SETTING--The STD outpatient clinic of the Department of Dermatovenereology of Sahlgrenska Hospital, Göteborg, Sweden. RESULTS--In 79 (90%) of 88 patients HPV DNA was detected by dot blot. Of 51 cases examined by histology 88% disclosed an evident koilocytosis. "High-risk" HPV types (16, 18, 31, 33, 35) were demonstrated in 8% of acuminate, 24% of papular and 56% of macular lesions. In 29% of 51 lesions examined histologically moderate to severe dysplasia was observed. There was a significant correlation between "high-risk" HPV types and dysplasia. CONCLUSION--"High-risk" HPV types are prevalent in papular and especially macular penile condyloma-like lesions. The histological finding of koilocytosis concomitant with dysplasia strongly indicates infection with a "high-risk" HPV type. Although the risk of penile cancer is low, it is from an epidemiological point of view important to diagnose these lesions. Until simple tests for HPV typing are available, biopsy for light microscopy (histology) should be obtained liberally from papular and macular condyloma-like lesions. In atypical cases of balanoposthitis HPV aetiology should also be considered.
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