A 43-Year-Old Man Comes to the Office Due to Increasing

A 43-year-old man comes to the office due to increasing discomfort and pain with sitting for the past several months.  He also has had occasional perianal pruritus.  Physical examination shows multiple, cauliflower-shaped, verrucous growths measuring 1 to 2 cm on the perianal skin.  Histopathologic examination of one of the lesion reveals hyperplastic papillary squamous epithelium with parakeratosis, nuclear irregularity, and "perinuclear halos" of cytoplasmic vacuolization.  Which of the following additional studies is most appropriate for this patient at this time?

A) Adhesive paddle test with microscopy
B) Colonoscopy with terminal ileoscopy
C) Darkfield microscopy of the tissue
D) Hepatic venous pressure measurement
E) HIV antigen and antibody testing

Correct Answer:

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