“…2 They are refractory to conventional therapy 2,8 and associated with a high incidence of recurrence, 8,9 and there is high-grade dysplasia in 30 percent of patients. 5,6,[10][11][12][13][14][15] Progression from in situ to invasive carcinoma also has been described, 11 occurring in most cases at the anal canal transitional zone. 16 Some features of the disease have been associated with the increased probability of developing dysplasia in anal condylomata: anal intercourse and HIV seropositivity, 10,12,14,17 immunodeficiency, 18 advanced HIV-infection status, 4 warts above the dentate line, 14 T CD4ϩ lymphocyte counts of Ͻ500/ mm 3 , 13,18-21 and HPV type.…”