Which procedure is used to confirm condyloma acuminatum?

• A. KOH preparation
• B. PCR for HPV
• C. Visual inspection alone
• D. Biopsy

Answer: (D)

Biopsy provides histologic confirmation of condyloma acuminatum. While genital warts from HPV often have a characteristic appearance, a tissue sample examined under the microscope is the most reliable way to confirm the diagnosis and to rule out other lesions, including premalignant or malignant changes. On histology, you’d look for HPV-related changes such as koilocytosis (koilocytes with perinuclear halos), along with features like acanthosis and papillomatosis, which support condyloma.

KOH preparation is for fungal infections and won’t confirm condyloma. PCR for HPV can detect viral DNA but does not distinguish a benign wart from other HPV-related lesions and doesn’t provide the same histologic confirmation. Visual inspection alone may be suggestive but isn’t definitive.