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To the Editor.—
We wish to comment on the recent editorial note concerning the diagnosis and epidemiology of condyloma acuminatum.1 The Centers for Disease Control analysis of the data collected by the National Disease and Therapeutic Index (NDTI) referred to grossly visible papillomata caused by the human papilloma virus (HPV), occurring in the anogenital region in both sexes. Recently, however, many articles2-4 have appeared documenting that, at least in women, most HPV lesions are flat, subclinical epithelial proliferations occurring on the cervix or in the vagina that can only be detected by colposcopy.The previously held view that cervical HPV infection was rare has now, as a consequence of improved cytological diagnosis, given way to the recognition that HPV-associated cellular atypia is the most frequent abnormality noted on Papanicolaou smears.2 Moreover, HPV-associated changes are seen in a substantial proportion of cervical intraepithelial neoplastic lesions. Cytological diagnosis of
Katz RL, Weiss KM. Diagnosis and Epidemiology of Condyloma Acuminatum. JAMA. 1984;251(8):1028–1029. doi:10.1001/jama.1984.03340320018016
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