# Correlation between Acetowhite Examination, Dermoscopy, and Histopathology in Patients with Anogenital Warts

## TL;DR

This study compares non-invasive methods like acetowhite examination and dermoscopy to histopathology for diagnosing anogenital warts, finding that dermoscopy is highly accurate.

## Contribution

The study provides a direct comparison of diagnostic accuracy between acetowhite examination, dermoscopy, and histopathology for anogenital warts.

## Key findings

- Acetowhite examination had 91% sensitivity but low specificity and NPV.
- Dermoscopy showed 100% sensitivity and specificity, making it highly accurate.
- Dermoscopy can reduce the need for invasive histopathological procedures.

## Abstract

Anogenital warts, caused by human papillomavirus (HPV) infection, are characterized by papular lesions in the anogenital region. Acetowhite examination and dermoscopy are non-invasive methods that might aid in confirming the clinical diagnosis. This study aimed to evaluate the diagnostic accuracy of acetowhite examination and dermoscopy compared to histopathological findings in anogenital warts. This cross-sectional study included patients diagnosed with anogenital warts at Dr. M. Djamil Padang Hospital (Padang, Indonesia) from January 2023 to December 2023. Using the purposive sampling method, 62 lesions from 54 patients (28 men and 26 women) aged 16-59 years were analyzed. Each lesion underwent acetowhite examination, dermoscopy, and histopathological examination. Descriptive analyses were performed on subject characteristics and dermoscopic features, while sensitivity and specificity were calculated using a 2×2 table. The majority of lesions were found in the perianal area in men (44%) and the vulva in women (39%). The acetowhite examination demonstrated a sensitivity of 91% but lacked specificity and negative predictive value (NPV), indicating limitations in identifying negative results. In contrast, dermoscopy exhibited 100% sensitivity and specificity. The findings indicated that both acetowhite examination and dermoscopy were effective diagnostic tools for anogenital warts, with dermoscopy providing exceptional accuracy. These non-invasive methods could potentially reduce the need for more invasive histopathological procedures. Dermoscopy, in particular, serves as a sensitive and specific adjunct tool, offering reliable diagnostic capabilities that can enhance clinical practice.