To visualize subclinical HPV lesions on the penile shaft, what is the recommended method?

• A. Apply acetic acid to the penile shaft and look for acetowhite changes
• B. Biopsy of lesions
• C. Visual inspection with Wood’s lamp
• D. Fluorescein staining

Answer: (B)

Subclinical HPV infections on the penile shaft are not reliably seen with routine inspection. The most reliable way to confirm HPV involvement when lesions aren’t clearly visible is to obtain tissue and examine it histologically. A biopsy provides definitive evidence of HPV-related changes (such as koilocytosis and HPV-compatible histology), allowing confirmation even when surface visualization is poor.

Noninvasive methods like applying acetic acid can highlight acetowhite areas in some contexts, but they are not definitive for subclinical penile infections and aren’t a replacement for histologic confirmation. Wood’s lamp and fluorescein staining aren’t useful for detecting HPV.