Diagnosis of condylomata lata begins with a history and physical examination. A healthcare provider may ask about the individual’s sexual history and any prior episodes of sexually transmitted diseases. In most cases, condylomata lata can be easily identified and diagnosed through physical examination of the affected area(s). Examination of the lesion under magnification using a colposcope may also be used if a more detailed evaluation is required.
Oftentimes, diagnosis can be confirmed by additional diagnostic testing, including serologic tests, which are blood tests detecting the presence of antibodies against Treponema pallidum. Dark-field microscopy, a specialized microscope, can be used to directly visualize the spirochetes. A biopsy may be needed to better differentiate syphilitic condylomata from HPV-induced lesions (e.g. genital warts) or from cancerous lesions. The visualization of numerous spirochetes by immunostaining, which is the process of selectively identifying proteins in cells, can also confirm the diagnosis of condylomata lata.
Treatment of condylomata lata requires treatment of the underlying syphilis infection. The first-choice treatment for all manifestations of syphilis is an intramuscular injection of the antibiotic, penicillin. For individuals allergic to penicillin, alternatives, such as doxycycline, ceftriaxone, or penicillin desensitization, where induced tolerance to penicillin occurs, may also be administered. It may take a few months for condyloma lata to resolve completely.
