[Management of external genital warts by dermatologists: a French survey]

Abstract

Background: External genital wart is the most frequent sexually transmitted disease. While there are guidelines for management and treatment, no data about primary care of this viral disease is available in France. So, we conducted a survey on French dermatologists'management of external genital warts.

Methods: In July and August 2001, a questionnaire - including questions on physicians and patients, sexually transmitted diseases, partners, clinical and viral evaluations, treatments, and follow-up - was mailed to 652 French dermatologists (randomization of 20 p. 100 of French dermatologists).

Results: Three hundred and fifty (53 p. 100) responses were returned. Dermatologists were mainly exclusively office practitioners (58 p. 100). Thirty-six percent of them were taking care of more than 3 patients per month with external genital warts. Patients were essentially men and immunocompetent. Only 52 p. 100 of physicians systematically performed a sexually transmitted disease evaluation, 38 p. 100 a partner evaluation, and 17 p. 100 a local evaluation for external genital warts. Biopsy was occasionally performed by 48 p. 100 of physicians, mainly in order to confirm diagnosis. Viral genotyping was rare. Cryotherapy (84 to 93 p. 100) and podophyllotoxin (40 to 55 p. 100) were the two treatments used as first line therapy, while laser (61 to 71 p. 100), and imiquimod (39 to 48 p. 100) were second line therapies. Sixty-three percent of physicians proposed a systematic clinical control after clinical recovery.

Conclusion: This large survey represents an overview on general practice concerning external genital warts among French dermatologists. Our study points out the lack of global management (loco-regional, partner, and STD evaluation) of the disease by dermatologists.