Recalcitrant anogenital warts: The importance of systemic evaluation beyond local therapy

Abstract Human papillomavirus causes varied manifestations of anogenital warts in both males and females. Recalcitrant and extensive warts require initial aggressive therapy generally. We report a case of a 63-year-old female with extensive, grey to hyperpigmented, verrucous plaques extending over bilateral labia majora, minora, mons pubis, and perineal region who was unresponsive to local therapy until her underlying intrinsic cause was investigated and treated. This case highlights the need for periodic detailed evaluation of immunosuppression in an unresponsive individual.