{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:03:59Z","timestamp":1791295439792,"version":"4.1.0"},"reference-count":107,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This guideline is an update of the 2011 European Guideline for the Management of Anogenital Warts. It is intended to support best practice in the care of patients with anogenital warts by including evidence\u2010based recommendations on diagnosis, treatment, follow\u2010up and advice to patients. It is intended for use by healthcare professionals in sexual healthcare or dermato\u2010venereology clinics in Europe but may be adapted for use in other settings where the management of anogenital warts is undertaken. As a European guideline, recommendations should be adapted according to national circumstances and healthcare systems. Despite the availability of vaccine to prevent HPV types 6 and 11, the cause of &gt;95% anogenital warts, they remain an important and frequent health problem. The previous systematic review of randomized controlled trials for anogenital warts was updated. The changes in the present guideline include the following: Updated background information on the prevalence, natural history and transmission of human papillomavirus (HPV) infection and anogenital warts. Key recommendations for diagnosis and treatment have been graded according to the strength of the recommendation and the quality of supporting evidence. 5\u2010fluorouracil, local interferon and photodynamic therapy have been evaluated and included as potential second\u2010line treatment options. Evidence of the impact of HPV vaccination on the incidence of anogenital warts has been updated.<\/jats:p>","DOI":"10.1111\/jdv.16522","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T09:36:58Z","timestamp":1596188218000},"page":"1644-1653","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":119,"title":["2019 IUSTI\u2010Europe guideline for the management of anogenital warts"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9572-193X","authenticated-orcid":false,"given":"R.","family":"Gilson","sequence":"first","affiliation":[{"name":"Centre for Clinical Research in Infection and Sexual Health Institute for Global Health University College London London UK"},{"name":"The Mortimer Market Centre, Central and North West London NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7417-8440","authenticated-orcid":false,"given":"D.","family":"Nugent","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research in Infection and Sexual Health Institute for Global Health University College London London UK"},{"name":"The Mortimer Market Centre, Central and North West London NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3209-1392","authenticated-orcid":false,"given":"R.N.","family":"Werner","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergy Division of Evidence\u2010Based Medicine (dEBM) Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin Humboldt\u2010Universit\u00e4t zu Berlin Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Ballesteros","sequence":"additional","affiliation":[{"name":"Centro Sanitario Sandoval Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4193-6919","authenticated-orcid":false,"given":"J.","family":"Ross","sequence":"additional","affiliation":[{"name":"University Hospital Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"British HIV Association (BHIVA) Working Group for NHS Evidence Accreditation of BHIVA guidelines.British HIV Association (BHIVA) Guideline Development Manual. URLhttps:\/\/www.bhiva.org\/file\/jgCacHqmuxZFL\/GuidelineDevelopmentManual.pdf(last accessed: 4 February 2019)]."},{"key":"e_1_2_7_3_1","unstructured":"British Association for Sexual Health and HIV.UK National Guidelines on the Management of Anogenital Warts 2015URLhttps:\/\/www.bashh.org\/documents\/UK%20national%20guideline%20on%20Warts%202015%20FINAL.pdf(last accessed: 4 February 2019)."},{"key":"e_1_2_7_4_1","unstructured":"Centers for Disease Control and Prevention.2015 Sexually Transmitted Diseases Treatment Guidelines. URLhttps:\/\/www.cdc.gov\/std\/tg2015\/default.htm(last accessed: 4 February 2019)."},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1111\/ddg.13441","article-title":"S2k guideline: HPV\u2010associated lesions of the external genital region and the anus \u2010 anogenital warts and precancerous lesions of the vulva, the penis, and the peri\u2010 and intra\u2010anal skin (short version)","volume":"16","author":"Gross GE","year":"2018","journal-title":"J Dtsch Dermatol Ges"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.22111"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.37.10.3316-3322.1999"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-39"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.07.055"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir644"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1086\/657321"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/427557"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1086\/656368"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir652"},{"key":"e_1_2_7_15_1","first-page":"1","article-title":"Natural history of genital warts","volume":"47","author":"Oriel JD","year":"1971","journal-title":"Br J Vener Dis"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.olq.0000245960.52668.e5"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.303.6812.1243"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3182215512"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.039982"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-1065"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1258\/0956462981921143"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2007.029512"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1086\/653426"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.2503"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910320507"},{"key":"e_1_2_7_26_1","first-page":"445","article-title":"Giant condyloma acuminatum \u2010 Buschke\u2010Lowenstein disease \u2010 a literature review","volume":"109","author":"Spinu D","year":"2014","journal-title":"Chirurgia (Bucuresti)"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-3083.2001.00196.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(90)90424-C"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1258\/0956462961918400"},{"key":"e_1_2_7_30_1","first-page":"263","article-title":"Podophyllotoxin 0.5% v podophyllin 20% to treat penile warts","volume":"64","author":"Edwards A","year":"1988","journal-title":"Genitourin Med"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(89)92282-4"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.3109\/09546639009086712"},{"key":"e_1_2_7_33_1","first-page":"105","article-title":"Self\u2010treatment using 0.25%\u20100.50% podophyllotoxin\u2010ethanol solutions against penile condylomata acuminata: a placebo\u2010controlled comparative study","volume":"70","author":"Krogh G","year":"1994","journal-title":"Genitourin Med"},{"key":"e_1_2_7_34_1","first-page":"387","article-title":"Topical treatment of genital warts in men, an open study of podophyllotoxin cream compared with solution","volume":"71","author":"Strand A","year":"1995","journal-title":"Genitourin Med"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.79.4.270"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181f68ebb"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052768"},{"key":"e_1_2_7_38_1","volume-title":"Poster IPVC8\u20100882 presented at the 32nd International Papillomavirus Conference, Sydney, 2\u20106 October 2018","author":"Gilson R"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(98)70243-9"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.42.4.789"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.134.1.25"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200104000-00007"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2004.tb00568.x"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1258\/095646206777689161"},{"key":"e_1_2_7_45_1","first-page":"642","article-title":"Randomized, comparative trial on the sustained efficacy of topical imiquimod 5% cream versus conventional ablative methods in external anogenital warts","volume":"16","author":"Schofer H","year":"2006","journal-title":"Eur J Dermatol"},{"key":"e_1_2_7_46_1","first-page":"CD010389","article-title":"Imiquimod for anogenital warts in non\u2010immunocompromised adults","author":"Grillo\u2010Ardila CF","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31815ea8d1"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/806105"},{"key":"e_1_2_7_49_1","first-page":"277","article-title":"Imiquimod cream 2.5% and 3.75% applied once daily to treat external genital warts in men","volume":"96","author":"Rosen T","year":"2015","journal-title":"Cutis"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2005.06.001"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.09.020"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.600795"},{"key":"e_1_2_7_53_1","first-page":"1","article-title":"Cancer chemoprevention by tea polyphenols","volume":"24","author":"Lin JK","year":"2000","journal-title":"Proc Natl Sci Counc Repub China B"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.3109\/08923973.2014.953637"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2007.02441.x"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2008.08520.x"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181719b60"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2010.03796.x"},{"key":"e_1_2_7_59_1","first-page":"390","article-title":"Cryotherapy compared with trichloroacetic acid in treating genital warts","volume":"63","author":"Godley MJ","year":"1987","journal-title":"Genitourin Med"},{"key":"e_1_2_7_60_1","first-page":"16","article-title":"Treatment of external genital warts: a randomised clinical trial comparing podophyllin, cryotherapy, and electrodesiccation","volume":"66","author":"Stone KM","year":"1990","journal-title":"Genitourin Med"},{"key":"e_1_2_7_61_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.2340\/00015555723940","article-title":"Non\u2010specific immunity in patients with primary anogenital warts treated with interferon alpha plus cryotherapy or cryotherapy alone","volume":"72","author":"Handley JM","year":"1992","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1258\/095646207781024711"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2007.007196"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.038075"},{"key":"e_1_2_7_65_1","first-page":"187","article-title":"CO2 laser therapy versus cryotherapy in treatment of genital warts; a randomized controlled trial (RCT)","volume":"4","author":"Azizjalali M","year":"2012","journal-title":"Iran J Microbiol."},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20141702"},{"key":"e_1_2_7_67_1","first-page":"151","article-title":"Liquid nitrogen cryotherapy versus 70% trichloroacetic acid in the treatment of anogenital warts: A randomized controlled trial","volume":"18","author":"Lotfabadi P","year":"2016","journal-title":"Iran J Dermatol J"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.04.012"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.12287_suppl"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.01.022"},{"key":"e_1_2_7_71_1","first-page":"26","article-title":"Survey of dermatologists and venereologists shows varying approach to penile biopsies","volume":"10","author":"Wernham A","year":"2017","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90705-C"},{"key":"e_1_2_7_73_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ813"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)92677-7"},{"key":"e_1_2_7_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90676-8"},{"key":"e_1_2_7_76_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800761027"},{"key":"e_1_2_7_77_1","doi-asserted-by":"publisher","DOI":"10.4103\/2249-4863.117403"},{"key":"e_1_2_7_78_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta20240"},{"issue":"3","key":"e_1_2_7_79_1","first-page":"393","article-title":"Randomized clinical trial comparing systemic interferon with diathermocoagulation in primary multiple and widespread anogenital condyloma","volume":"74","author":"Panici P","year":"1989","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_80_1","volume-title":"Human Papillomavirus Infection, A Clinical Atlas","author":"Gross GE","year":"1997"},{"key":"e_1_2_7_81_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2006.07648.x"},{"key":"e_1_2_7_82_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0781.2009.00467.x"},{"key":"e_1_2_7_83_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2009.01125.x"},{"key":"e_1_2_7_84_1","first-page":"CD006562","article-title":"5\u2010FU for genital warts in non\u2010immunocompromised individuals","author":"Batista CS","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_85_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053150"},{"key":"e_1_2_7_86_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-9-156"},{"key":"e_1_2_7_87_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198610233151704"},{"key":"e_1_2_7_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)90404-2"},{"key":"e_1_2_7_89_1","doi-asserted-by":"publisher","DOI":"10.1258\/0956462981921396"},{"key":"e_1_2_7_90_1","doi-asserted-by":"publisher","DOI":"10.1002\/tcr.201600121"},{"key":"e_1_2_7_91_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0781.2011.00592.x"},{"key":"e_1_2_7_92_1","doi-asserted-by":"publisher","DOI":"10.1080\/01480540802433757"},{"key":"e_1_2_7_93_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2004.10.020"},{"key":"e_1_2_7_94_1","doi-asserted-by":"publisher","DOI":"10.1258\/0956462961918248"},{"key":"e_1_2_7_95_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2011.03.001"},{"key":"e_1_2_7_96_1","doi-asserted-by":"publisher","DOI":"10.1258\/095646204322637191"},{"key":"e_1_2_7_97_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-007-9041-2"},{"key":"e_1_2_7_98_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-053035"},{"key":"e_1_2_7_99_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.75.5.312"},{"key":"e_1_2_7_100_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200211000-00018"},{"key":"e_1_2_7_101_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11474"},{"key":"e_1_2_7_102_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit191"},{"key":"e_1_2_7_103_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6602524"},{"key":"e_1_2_7_104_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11473"},{"key":"e_1_2_7_105_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.038273"},{"key":"e_1_2_7_106_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir637"},{"key":"e_1_2_7_107_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2014-051813"},{"key":"e_1_2_7_108_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052626"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.16522","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.16522","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdv.16522","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.16522","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:40:53Z","timestamp":1791294053000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.16522"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,31]]},"references-count":107,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1111\/jdv.16522"],"URL":"https:\/\/doi.org\/10.1111\/jdv.16522","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,31]]},"assertion":[{"value":"2019-05-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}