In Reply.—I am indebted to Gutman et al for their careful and critical analysis of this work.1 They may or may not be correct when they propose that the 27% incidence rate of sexual abuse found in this review was too low. As stated in the article, many authors believe that the presence of condylomata acuminata in children is all but pathognomonic of sexual assault.2-4 Conflicting evidence has also recently been presented.5,6 It should be noted that, while admirable, it was not the point of my article to apply the criteria for child abuse discussed in it to the cases currently in the literature.
The consideration of sexual contact should be entertained when any child presents with venereal warts. As Herman-Giddens2 has previously noted, those physicians who deal with pediatric venereal warts are hampered by the fact that methods for ascertaining the means of their acquisition are
BOYD AS. Diagnosis of Child Sexual Abuse in Children With Genital Warts-Reply. Am J Dis Child. 1991;145(2):126-127. doi:10.1001/archpedi.1991.02160020016005