Umbilicated Lesions or Genital Warts

What are umbilicated lesions?

The term umbilicated lesion refers to any wound on the skin that has a depression in the centre and resembles the navel or the umbilicus to a certain extent. Such lesions are generally noted on the skin as a part of the rashes noted in some skin disorders. Many skin disorders that include: leprosy, sarcoidosis, xanthoma, histiocytoma, keratoacanthoma, squamous cell carcinoma, pilar cyst, or lichen sclerosus have been noted to be associated with umbilicated lesions. Such lesions generally are noted to have a small depression in the centre that may resemble a hole. The term umbilicated has been used in reference to the similarity noted between such lesions and the umbilicus. In some cases vaccination sites on the skin such as small pox vaccination which is given during childhood may also have an umbilicated appearance. These lesions are generally noted on the skin surface and may appear anywhere on the body such as the face, hands, back or legs. Some lesions are even noted on the scalp.

The umbilicated lesions are commonly associated with a viral infection caused due to a virus known as molluscum contagiosum. This virus belongs to the pox virus family and is commonly known to infect children. Children usually acquire this infection by touching the infected children or infected skin surfaces.

The lesions associated with this viral infection are generally noted to begin as a small, painless skin eruption that gradually becomes raised over a period of few hours or days. Such eruptions are often called papules. These papules commonly have a depression in the centre. Also these umbilicated lesions may be noted to spread to nearby areas or across the body where the affected individual has scratched. These umbilicated lesions are generally painless. Such lesions can occur anywhere in the body except the palm and sole of the hands and feet. In case of children it is commonly noted on the face, armpits, neck and hands.
 In case of adults these lesions may spread by both touch and sexual contact with an infected individual. In such cases, the umbilicated lesions are generally noted in the genital region, on the genitals, abdomen and inner thigh regions.

What are genital warts?

Genital warts are raised skin lesions noted in the genital region of men and women. Genital warts are commonly associated with a viral infection caused by the human papilloma virus (shortly known as HPV). The HPV or the HPV infection is a sexually transmitted disorder that spreads due to sexual contact between and infected individual and a healthy individual. The disorder is commonly noted in adults or adolescents who have multiple sexual partners.

The genital warts commonly appear as raised, flesh colored lesions. Such lesions are generally noted on the genitals, anal region or surrounding skin surfaces. In some instances the genital warts resemble the shape of the cauliflower hence giving rise to the name, cauliflower-like lesions. Such changes are generally noted in untreated lesions wherein the small lesions tend to grow in size and in numbers.

These genital warts tend to grow well in the moist areas in the genital regions. While it may be easily spotted in men as raised lesions on the genitals, the genital warts may be difficult to be identified by self examination among women. Symptoms such as pain may be rarely noted unless the lesions are infected by other micro-organisms. Other symptoms that are generally associated with genital warts include: abnormal bleeding from the vagina following sexual intercourse (bleeding that is not associated with your regular menstrual periods), an increased amount of moisture or dampness around the warts, itching sensation, and an increase in the vaginal discharge.

What are the difference between genital warts and umbilicated lesions?

Numerous differences are noted between the genital warts and umbilicated lesions. A wide amount of differences in the aspects of the infectious organisms, the region of appearance, symptoms associated and many more.

Area of appearance:

Genital warts as the name implies are commonly noted in the genital regions while umbilicated lesions may appear anywhere in the body except the soles and the palms.

Age of occurrence:

While genital warts are commonly noted in adults and adolescents, umbilicated lesions occurring due to viral infections such as molluscum contagiosum is more commonly noted in children.

Mode of spread:

Genital warts occur exclusively following sexual contact with an infected individual while umbilicated lesions due to molluscum contagiosum can spread both due to touch and sexual contact.

Causative organism:

Human papilloma virus is the causative organism of genital warts. Umbilicated lesions are most commonly associated with a viral infection known as molluscum contagiosum. Other viruses can also cause umbilicated lesions

Appearance:

While the umbilicated lesions have a depression in the centre, genital warts may appear either as raised, flesh colored skin eruptions or have a ‘cauliflower like’ appearance.

Symptoms:

Umbilicated lesions are generally asymptomatic. Genital warts can result in abnormal vaginal bleeding in case of infected adults. The genital warts may also be itchy, and painful in some instances.

What are umbilicated lesions also mistaken for?

Many disorders and common skin conditions are associated with the appearance of raised nodules or papules on the skin. In many instances such eruptions may cause concern in the affected individuals. Umbilicated lesions are commonly confused or mistaken for genital warts. Other skin conditions include pearly papules commonly noted in the genital regions, a condition known as angiokeratoma (characterized by bright red or purplish spots on the skin), Fordyce spots (elevated yellowish or white papules that are a type of sebaceous gland and are noted in 80-85% of adults in the genital region) and the common pimples or acne (these can also form in the genital region as observed on the face and can be associated with similar symptoms).   

Some of the rare skin disorders that are associated with lesions similar to umbilicated lesions include skin conditions such as leprosy, sarcoidosis, xanthoma, histiocytoma, keratoacanthoma, squamous cell carcinoma, pilar cyst, or lichen sclerosus.

Such umbilicated or other lesions appearing especially in the genital regions need to be investigated for early diagnosis and prevention of complications.