A 22-year-old man who has sex with men is seen for a new evaluation of anal warts. Testing for HIV is negative.
Which one of the following best describes indications for performing biopsy of anogenital warts?

Figure 1. Perianal Condylomas with Atypical Characteristics: Pigmentation Changes
This image from high-resolution anoscopy (magnification 15x) shows perianal condyloma with a specific area (yellow circles) demonstrating hyperpigmentation and hypopigmentation. Biopsy of the lesion confirmed high-grade squamous epithelial lesion.
Photograph credit: Helen C. Stankiewicz Karita, MD

Figure 2. Perianal Condylomas with Atypical Characteristics: Pigmentation Changes
Circumferential perianal condylomas with hypo- and hyperpigmentation and areas with superficial ulceration. Biopsy of the lesion confirmed high-grade squamous epithelial lesion.
Photograph credit: Helen C. Stankiewicz Karita, MD
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Question Last Updated
March 10th, 2025
March 10th, 2025
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