Radiosurgical removal of a skin lesion - condyloma, 1 lesion

Radiofrequency cauterization of cutaneous lesions is a minimally invasive dermatological procedure that uses radiofrequency current for the precise and controlled removal of benign or superficial viral skin lesions.

Condyloma acuminata (genital warts) are papillomatous lesions of viral origin caused by the human papillomavirus (HPV). They are predominantly located in the genital and perianal regions and are most commonly associated with low-oncogenic-risk HPV types 6 and 11. Clinically, they appear as soft, wart-like growths, pink or brown in color, with a tendency to increase rapidly in number and size.

These lesions may become symptomatic, causing itching, burning sensation, local bleeding, and may significantly affect psychological well-being and sexual health. Without appropriate treatment, genital warts have a high risk of recurrence and can be transmitted through direct skin-to-skin contact.

Radiofrequency cauterization is an effective treatment method that enables the controlled destruction of infected tissue. The procedure is performed under local anesthesia, is quick, well tolerated, and promotes favorable cosmetic healing with a minimal risk of recurrence.

Components Evaluated Before the Procedure

• Number, size, and anatomical location of the lesions
• Associated symptoms: pruritus, pain, discharge, or local irritation
• History of recurrence or previous genital infections
• Patient's immune status (including chronic diseases, HIV infection, etc.)
• Assessment of oncogenic risk and differentiation from other lesions (e.g., Bowen's disease, carcinoma in situ)
• Pregnancy status (in female patients)

Purpose of the Procedure

• Elimination of the HPV infection focus
• Reduction of local symptoms (discomfort, bleeding, inflammation)
• Improvement of aesthetic appearance and functional comfort
• Reduction of the risk of transmission to sexual partners
• Collection of tissue for histopathological examination, when indicated

Indications

• Visible anogenital warts confirmed by clinical examination and dermoscopy
• Rapidly growing, symptomatic, or bleeding lesions
• Multiple or recurrent lesions
• Aesthetic or sexual discomfort
• Patient's wish to remove the lesions

Relative Contraindications

• Acute infection in the treatment area
• Suspicion of precancerous or malignant lesions
• Severe coagulation disorders
• Pregnancy (particularly during the first trimester, when the procedure may be postponed)

Procedure

• The treatment area is thoroughly disinfected.
• Local anesthesia (topical cream or injectable anesthetic) is administered.
• The lesions are excised or vaporized using a radiofrequency electrode.
• A local dressing is applied, and post-procedure care instructions are provided.

Estimated procedure time: 10–20 minutes

Healing time: approximately 7–10 days, during which a protective crust forms and detaches naturally.

Post-Procedure Recommendations

• Avoid sexual intercourse for 7–10 days.
• Maintain strict local hygiene.
• Apply antiseptic or topical medications as prescribed by the physician.
• Monitor the treated area for possible recurrence.
• Attend a follow-up examination after 3–4 weeks for reassessment.

Advantages

• Fast and effective lesion removal
• Low risk of complications or recurrence (when combined with appropriate adjunctive therapy)
• Excellent cosmetic healing with minimal scarring
• The procedure can be repeated in cases of recurrence
• May be combined with antiviral or immunomodulatory treatment when clinically indicated
   

Sources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC4835659/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8423214/
https://journals.lww.com/jdds/fulltext/2019/23010/comparative_study_of_efficacy_of_radiofrequency.7.aspx
https://www.dovepress.com/article/download/87171
https://ijdvl.com/standard-guidelines-for-electrosurgery-with-radiofrequency-current/ https://www.aafp.org/pubs/afp/issues/2015/1001/p601.html