A 43-year-old man comes to the office due to increasing discomfort and pain with sitting for the past several months. He also has had occasional perianal pruritus. Physical examination shows multiple, cauliflower-shaped, verrucous growths measuring 1 to 2 cm on the perianal skin. Histopathologic examination of one of the lesion reveals hyperplastic papillary squamous epithelium with parakeratosis, nuclear irregularity, and "perinuclear halos" of cytoplasmic vacuolization. Which of the following additional studies is most appropriate for this patient at this time?

Question

A 43-year-old man comes to the office due to increasing discomfort and pain with sitting for the past several months.  He also has had occasional perianal pruritus.  Physical examination shows multiple, cauliflower-shaped, verrucous growths measuring 1 to 2 cm on the perianal skin.  Histopathologic examination of one of the lesion reveals hyperplastic papillary squamous epithelium with parakeratosis, nuclear irregularity, and "perinuclear halos" of cytoplasmic vacuolization.  Which of the following additional studies is most appropriate for this patient at this time?

Quizplus · Accepted Answer

Eductional Objective: Condylomata acuminata (anogenital warts) present as pink- or skin-colored plaques, papules, and verrucous lesions on the genitalia, perineum, or perianal skin; they are caused by human papillomavirus, primarily types 6 and 11.  These lesions are associated with increased risk for HIV infection, and HIV testing is recommended.

A 43-Year-Old Man Comes to the Office Due to Increasing