Human papillomavirus can be transmitted via anoreceptive intercourse and result in anogenital warts (eg, condylomata acuminata).  Most warts are asymptomatic papules they are rarely associated with pain or fever.

fleshy, cauliflower-shaped masses. They are more common in individuals who engage in anal intercourse. Symptoms include itching, scant bleeding, and impaired anal hygiene.

A shave biopsy can confirm the diagnosis of anogenital warts and evaluate for malignancy, which is associated with high-risk human papillomavirus types. Findings that should raise concern for malignancy and are indications for biopsy include immunosuppression (e.g., HIV infection), insufficient response to treatment, and atypical features (e.g., induration, bleeding, pigmentation, ulceration), all of which are seen here. Evaluation with anoscopy should also be considered to evaluate for involvement within the anal canal.

Recurrence and refractory disease are common in patients with anogenital warts, especially in individuals with immunosuppression. Treatments for anogenital warts include cytodestructive therapies (e.g., trichloroacetic acid), immune-mediated therapies (e.g., imiquimod), and surgical therapies (e.g., cryoablation, excision).