CONDYLOMA

ACUMINATA and
PRURIGO NODULARIS
ERUPTION IN THE
PATIENT OF HIV

MUH. WIRAWAN HARAHAP

HESTINA LAMBONA
RAEHANA HURHIDAYAH

CASE REPORT
Name
Age

: Mr. IF
: 49 Years Old

Address

: Bontolaja Street, Gowa

Marital status
Religion

: Marriage

: Moslem

Add. Date : July 9th 2012

Reg. No.

: 251942

HISTORY TAKING
Chief Complain
: Itchy in whole body
Brief Anamnesis : The patient consuled from
interna department with complaints of itching of the
whole body on July 11th 2012. there is a lump in
almost the entire body since 6 months ago
especially on the part of both legs. There are
swelling in regio femoralis dextra, pain (-).
There is a mass on his scrotum like a cocks comb
that arise from a year ago.
History of fever 5 days before come to hospital.
History of drug abuse(+) like morfin since 1997.
History of hiv disease was diagnosed on 11 July
2012

PHYSICAL EXAMINATION
Anemic (-), icterus (-), cyanoses (-)
Thorax :
There is a mass in the left breast with rubbery
consistency and flat surfaces
Cor / Pulmonal : normal
Abdomen : normal, peristaltik(+)
Genitals
cauliflower

stemmed

vegetation

such

as

CURRENT STATUS

General status : moderate sickness

Conciousness : composmentis
Hygiene
: moderate
Nutritional status : inadequate
Vital signs :
BP
: 120/80 mmHg
HR
: 78 x/minute
RR
: 20x/minute
temp : 36,5 C

DERMATO-VENEREOLOGY STATUS
Regio : Regio pedis dextra et sinistra
Efl : Nodule hyperpigmentation
Regio : Regio intertriginous dextra et sinistra
Efl : Nodule
Regio : Regio genitalia
Efl : Stemmed vegetation such as
cauliflower

LABORATORY RESULT (9 July 2012)

WBC
RBC
HB
HCT
PLT
LYM
Creatine
NEUT
SGOT
SGPT

:
:
:
:
:
:

12,4 (10 3 /uL)

5,126 /uL)
14,4 (g/dL)
42,3 (%)
621 (10 3 /uL)
7,2 (%)
: 0,73 mg/dl
: 79,8 %
: 47 U/I
: 41 U/I

RECOMMENDED EXAMINATION
Acetowhitening
Biopsy

RESUME

Mrs.IF counseled from interna department with complaints of itching of the

whole body on July 11th 2012. there is a lump in almost the entire body
since 6 months ago especially on the part of both legs. There are
swelling in regio femoralis dextra , pain (-).
There is a mass on his scrotum like a cocks comb that arise from a year
ago. History of fever 5 days before come to hospital.
History of drug abuse (+) like morfin since 1997
History of hiv disease was diagnosed on 11 July 2012
His diagnosis is Condyloma Acuminata + Prurigo Nodularis Eruption

Physical examination : Moderate

Dermato-venerology status :
Regio : Regio pedis dextra et sinistra
Efl
: Nodule hyperpigmentation
Regio : Regio intertriginous dextra et sinistra
Efl
: Nodule
Regio : Regio genitalia
Efl
: Stemmed vegetation such as cauliflower

DIAGNOSIS
Condyloma Acuminata + Prurigo
Nodularis Eruption e.c.
Immunodeficiency

TREATMENT
Betametason cr
TCA (Trichloroasetic Acid)
Cetirizine 1x1

CONDYLOMA ACUMINATA
Condyloma acuminata is sexually transmitted
HPV infection of genital and perianal transition
mucosa.

PATHOGENESIS
Most commonly caused by HPV 6 and 11 which
are not oncogenic. Important to exclude
infection with HPV 16 and 18 which are
oncogenic. In affected women, HPV analysis of
pap smear may supplement cytology to assess
risk.

CLINICAL MANIFESTATION
Incubation period 4 weeks 6 months.
Tiny white papules which rapidly both spread and
enlarge. Larger lesions often macerated. May be genital
or perianal.

DIAGNOSIS
Always examine sexual partner and exclude other STDs.
Painting with 5% acetic acid will unmask discrete
lesions by turning them white. Be sure affected women
have cervical examination. If lesions are recalcitrant,
consider HPV typing.

DIFFERENTIAL DIAGNOSIS
Verruca vulgaris
Condyloma lata
Squamous cell carsinoma

TREATMENT
Non-surgical

: Podofillin, podofilotoksin, 5-FU (5-

fluorourcil), trichloroacetic acid (TCA), imiquimod,

interferon (IFN)
Surgical

cryotherapy,

surgical

electrocoagulation, and laser surgery

excision,

PROGNOSIS
Although even residif, but the prognosis
is good

THANK YOU