| Etiology | • Human papillomavirus infection |
|---|---|
| Transmission | • Sexual abuse |
| • Auto inoculation from other sites | |
| • Prenatal or perinatal | |
| Clinical features | • Pink/flesh-colored, verrucous papules & plaques |
| • Asymptomatic (most common) | |
| • Pruritic, friable lesions | |
| Management | • Sexual abuse assessment, especially age ≥4 |
Most lesions are asymptomatic, but they can become pruritic and friable, which can cause bloody spotting in patients' underwear. Condyloma acuminata are due to infection with low-risk human papillomavirus (HPV) types 6 and 11, which are typically transmitted via direct contact.
HPV can be transmitted via nonsexual contact such as vertical transmission during delivery, autoinfection from other areas of the body, or heteroinoculation from a caregiver (eg, diaper changes). However, because of the association with transmission via direct genital contact, an assessment for sexual abuse is required in all children, particularly those age ≥4.
Anogenital warts in children are often self-resolving; therefore, asymptomatic patients typically require only observation. For those with symptomatic or unresolved disease, management options include topical treatments (eg, podophyllotoxin) and surgical removal.