Genital herpes simplex is a viral infection that is caused by herpes simplex virus type 2 (HSV-2) and herpes simplex virus type 1 (HSV-1). It is frequently seen in sexually active adolescents but can also occur in younger children. Nonsexual acquisition by vertical transmission can take place at the time of birth, by hand contact during diapering, or by autoinoculation. However, new genital herpetic lesions in children without a history of perinatal acquisition who have independent toileting are suspicious for abuse and should be evaluated. Both types may be due to sexual abuse. An associated history of recurrent herpes gingivostomatitis or herpetic whitlow argues against abuse.

Infection by the virus is acquired from direct contact with active lesions, and symptoms develop within 5-10 days of initial contact. However, it is important to note that even when asymptomatic, a person sheds the virus and so can transmit the disease to another. In some adolescents, primary infection can be severe and include symptoms of aseptic meningitis such as fever, headache, stiff neck, and photophobia. In girls, there can be severe local symptoms of pain, dysuria, and vaginal discharge.

Childhood sexual abuse is a problem of epidemic proportions affecting children of all ages and of all economic and cultural backgrounds. Although awareness is increasing, it is often challenging to differentiate findings attributable to child abuse from those of other benign anogenital skin conditions.