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Colposcopy of perineum and anal canal
1. Perianal and anal HPV infection
In women it is important to look for HPV infection and neoplasia as the problem which affects large area of epitelium of the same origin. It extends backwards to perianal regia, anus and rectal region. Source of infection, most likely, is the infected vulva. As on all other parts of lower genital system it can be clinical and subclinical.
Clinically anogenital warts may have very different appearance, from discrete small papules to large cauliflower growth. They are generally divided to condylomata acuminata and papular changes. Condylomata acuminata may be exuberant in perianal region and their appearance is equal as elsewhere.
HPV induced papular lesions are smaller and less common. They can be pigmented or non pigmented. They are more flat and not verrucous. Histologically HPV infection is evident.
Subclinical infection often appears around the anus and perianal area. It is usually multicentric, affecting more sites. Colposcopical characteristics are equal to those for vulva and most often the lesions are visible as white fields visible after the application of acetic acid.
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