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2017 ; 92
(5
): 675-681
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Anogenital warts in pediatric population
#MMPMID29166505
Costa-Silva M
; Fernandes I
; Rodrigues AG
; Lisboa C
An Bras Dermatol
2017[Sep]; 92
(5
): 675-681
PMID29166505
show ga
The approach to children with anogenital warts in the context of sexual abuse is
a challenge in clinical practice. This study aims to review the current knowledge
of anogenital warts in children, the forms of transmission, and the association
with sexual abuse and to propose a cross-sectional approach involving all medical
specialties. A systematic review of the literature was conducted in Portuguese
and English from January 2000 to June 2016 using the ISI Web of Knowledge and
PubMed databases. Children aged 12 years or younger were included. The ethical
and legal aspects were consulted in the Declaration and Convention on the Rights
of Children and in the World Health Organization. Non-sexual and sexual
transmission events of human papillomavirus in children have been well
documented. The possibility of sexual transmission appears to be greater in
children older than 4 years. In the case of anogenital warts in children younger
than 4 years of age, the possibility of non-sexual transmission should be
strongly considered in the absence of another sexually transmitted infection,
clinical indicators, or history of sexual abuse. The importance of human
papillomavirus genotyping in the evaluation of sexual abuse is controversial. A
detailed medical history and physical examination of both the child and
caregivers are critical during the course of the investigation. The likelihood of
an association between human papillomavirus infection and sexual abuse increases
directly with age. A multidisciplinary clinical approach improves the ability to
identify sexual abuse in children with anogenital warts.
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