Anogenital warts in children: The dilemma of distinguishing between sexual abuse or other transmission routes.

Abstract

Determining the cause of anogenital warts in children can be difficult, as the human papillomavirus (HPV) can infect children through various routes. Suspicion of sexual abuse must always be evaluated in the management of such cases. The current clinical case aims to increase the awareness of doctors in identifying the route of transmission of anogenital warts in children. A six-year-old boy presented with multiple papules in the perianal and anal areas. There was no evidence of sexual abuse in the medical history. Dermatological examination and histopathology confirmed the diagnosis of anogenital warts. No clinical features indicative of sexual abuse were observed. HPV genotyping was negative. The child was treated with trichloroacetic acid at a concentration of 60-80% with good results at the follow-up visit after one week. In such cases, a thorough medical history of the patient, family and other subjects who have had contact with the child is essential to investigate the possibility of sexual abuse. Physical examination is also important to check for the presence of lesions attributable to sexual abuse. Finally, a multidisciplinary approach is necessary.