Successful treatment of giant condyloma acuminata in HIV-positive patient with a combination of ligation and 80% trichloroacetic acid

Introduction
Giant condylomata acuminata are caused by human papillomavirus, characterized by a large, slow-growing, and locally invasive cauliflower-like lesion located in the anogenital region. Transmission of this virus is mainly sexual, with the most common types of human papillomavirus that cause anogenital warts being human papillomavirus types 6 and 11. The prevalence of giant condyloma acuminata increased significantly especially in immunocompromised patients such as patients infected with the human immunodeficiency virus. Treatment modalities for condyloma acuminata include topical therapy, physical removal of the lesion with cryotherapy, electrocautery, laser, photodynamic therapy, or surgical excision.

Objective
We present a case report of giant condyloma acuminata in the perianal region in an immunocompromised 31-year-old man with human immunodeficiency virus which developed rapidly within 6 months.

Case report
The patient underwent a combination of ligation and topical therapy using 80% trichloroacetic acid for 4 months. After 3 months of follow-up, the patient had no recurrence, with good functional outcome.

Conclusions
The use of loop ligation prior to 80% trichloroacetic acid can be considered a potent and cost-effective treatment option for giant condylomata acuminata.