Giant Condyloma Accuminata in Pregnancy, Use of Trichloroacetic Acid combined with electrocauterization and excision Procedure: A Case Report

Putri Cinthya Ismihari,Riyana Noor Oktaviyanti

doi:10.30595/hmj.v4i3.10252

Abstract

Condyloma acuminata is a sexually transmitted disease caused by the Human Papilloma Virus (HPV). During pregnancy, condyloma acuminata can proliferate rapidly due to changes in immunity and increased blood supply. One of the safest therapeutic modalities is trichloroacetic acid (TCA). Electrocautery is another modality in pregnant patients. A 16-year-old woman, 6-months pregnant, complained of a wart-like lump in the pubic area getting more prominent since the last two weeks and covering the vagina surface. The lump is not itchy and painless. From history-taking it was found that patient often changes partners. On physical examination, the lesions were multiple papules with a verrucous surface. The results of the work-up showed a positive acetowhite test. Patients are then treated with a TCA of 80-90% during pregnancy and followed by electrocautery and excision during cesarean section. The results of 80-90% TCA treatment followed by electrocautery and excision were satisfactory, and there were no recurrences when the patient went for a follow-up. TCA is a substance that is caustic and can erode skin and mucous membranes. TCA works by coagulation of proteins which causes dryness of cells and tissues. TCA is safe for pregnant women. Combination of TCA 80-90% with electrocautery and excision, in this case, proved to be effective with no sign of recurrence. The combination of TCA therapy with electrocautery and excision has proven effective and safe for pregnant patients.

Highlights

Condyloma acuminata (CA) or better more genital Human Papilloma Virus (HPV) strains
Based on Matsunaga's research in 1987, it was explained that condyloma acuminata mainly were transmitted through sexual contact, (9) this is in accordance with the patient in this case, where the source of transmission comes from patients who frequently change partners and have sex without using a condom
The incidence of condyloma acuminata often occurs in young adolescents who are already sexually active, where the highest frequency of infection occurs in the adult group aged 18-28 years

Summary

Introduction

Condyloma acuminata (CA) or better more genital HPV strains. The highest incidence rate known by the general public as genital warts or occurs in the adult group aged 18-28 years.[3] chicken's comb disease, is classified as a sexually. The primary therapeutic modality for condyloma acuminata is destructive therapy, such as cauterization, cryotherapy with liquid nitrogen, excision, podophyllin tincture, podophyllin resin, trichloroacetic acid (TCA), injection of bleomycin sulfate, imiquimod cream, and laser vaporization None of these modalities totally effective, and recurrences are common.[1] In pregnant women, not all of the above therapeutic modalities are viable. Combination with cautery and excision increases the success rate of therapy.[7] Case Illustration: An unmarried 16-year-old woman, six months pregnant, came with a complaint of having a wart-like lump in the pubic area 2 weeks ago. This woman had never experienced this complaint before. Large wart/condyloma lesions were performed electrocautery and excision during the caesarean section

Discussion

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Conclusion