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Genital wart in Child
See also in: Anogenital
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Genital wart in Child

See also in: Anogenital
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Contributors: Priyanka Vedak MD, Susan Burgin MD, Craig N. Burkhart MD, Dean Morrell MD
Other Resources UpToDate PubMed

Synopsis

Condyloma acuminata are warts that occur secondary to infection with the human papillomavirus (HPV), a double-stranded DNA that belongs to the family of Papillomaviridae. The incubation period from exposure to lesion development can last from months to years.

In children, HPV infections can present as common skin warts, anogenital warts, oral and laryngeal papillomas, and subclinical infections. HPV types 1, 2, 3, 4, 7, and 10 cause skin warts in children, with incidence peaking at ages 12-16 years. HPV types 6 and 11 account for most genital and oral warts, while types 16 and 18 cause both genital warts and genital malignancies. HPV infection causes oropharyngeal and anal cancers in both genders: cervical, vaginal, and vulvar cancer in women and penile cancer in men.

Note: Childhood sexual abuse is a problem of epidemic proportions affecting children of all ages and of all economic and cultural backgrounds. A critical consideration for assessing condyloma acuminata in children is the determination of whether inoculation occurred as a result of sexual abuse. However, anogenital warts from HPV can also occur secondary to perinatal exposure, heteroinoculation (eg, from caregiver a changing diapers), autoinoculation (eg, from a wart on the hand of child), and indirect fomite transfer (eg, from shared towels). Large case series have found that about 3%-10% of anogenital warts in children are due to child sexual abuse.

Related topic: Oral mucosal wart

Codes

ICD10CM:
A63.0 – Anogenital (venereal) warts

SNOMEDCT:
240542006 – Condyloma acuminatum

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

There are many verrucous-looking lesions of the genitals:
  • Pearly penile papules – May be seen as early as the second decade of life.
  • Acrochordons
  • Lichen planus
  • Lichen nitidus
  • Molluscum contagiosum – Shiny papules with central umbilication; giant molluscum in the anogenital area of children have been mistaken for condyloma acuminatum.
  • Seborrheic keratoses
  • Melanocytic nevi
  • Fordyce spots
  • Psoriasis
  • Nodules of scabies
  • Epidermal nevus
  • Pseudoverrucous papules and nodules in association with chronic fecal incontinence.
  • Condyloma lata (secondary syphilis) – Lesions tend to be flatter and smoother than condyloma acuminata.
  • Hymenal remnants
  • Vestibular papillae (also known as vulvar papillomatosis, a normal variant of female external genitalia) – Softer than condyloma, and symmetrically or linearly distributed compared to irregular distribution of condyloma; base of individual lesions remains separate compared to coalescing of superficial projections seen in condyloma.
If a condyloma acuminatum is solitary, neoplasms – although rare – should be considered in children.

Best Tests

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Therapy

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References

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Last Reviewed: 11/21/2017
Last Updated: 11/21/2017
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Genital wart in Child
See also in: Anogenital
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Genital wart : Verrucous scaly papule, Verrucous scaly plaque
Clinical image of Genital wart
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