A sixty-year-old patient was hospitalized at the Second Department of Internal Medicine for the investigation of anemia. B₁₂ deficiency was revealed, and the relevant supplementation was initiated. A clinical skin examination revealed a huge, brown, polypoidal mass covering the entire inguinal area that had been there for the last nine years (Fig. 1). Neither rectal nor anal lesions were observed. During hospitalization, the patient was infected with COVID-19 and, after treatment, was discharged from the hospital without any further dermatological consultation. Laboratory examination for syphilis and HIV was negative. It was a giant condyloma acuminata.

Figure 1: Giant condyloma acuminata in the inguinal region.

Giant condyloma acuminata is a rare disease affecting 0.1% of the population, mainly immunocompromised patients suffering from diabetes, cancer, following transplantation, and is associated with HPV 6 [1] and 11 strains yet also 16 and 18, the high-risk ones [2]. It often recurs and may be transformed into squamous cell carcinoma. Treatment includes immunomodulator agents such as imiquimod, surgical excision, and non-invasive methods such as local hyperthermia [3].

Final diagnosis: giant condyloma acuminata.

Three differential diagnoses: skin tags, molluscum contagiosum, condyloma latum.

REFERENCES

1. Nassiri A, Aqil N, Baybay H, Mernissi FZ, Souhli OA, Ahssaini M, et al. Extra genital HPV-6. Our Dermatol Online. 2019;10:71-3.

2. Bachaspatimayum R, Zamzachin G, Devi TB. Clinical and laboratory profiles of genital ulcers (sexually transmitted diseases) in a tertiary care center in northeastern India. Our Dermatol Online. 2021;12:120-9.

3. Ganjoo S, Mishra P, Sawhney MPS, Sharma U, Chhabra N. Successful ablation of giant condyloma acuminata in an adolescent. Our Dermatol Online. 2021;12:430-2.