Sir.—A number of points about the recent article by Boyd1 on human papillomavirus (HPV) genital infections in children need to be made so that pediatricians and other concerned professionals, such as Family Court judges, are not confused or misled by this attempt at a "metaanalysis" of previous case reports.
First, as Disraeli once noted, "There are lies, there are damned lies, and there are statistics!" I have a very basic quarrel with Boyd's statistical analysis because he analyzes all cases together. One major question—how often condylomata acuminata are representative of sexual transmission, ie, sexual abuse in children—does not lend itself to this "lumping" of data.
To answer this important question, one must exclude children younger than age 1.5 years, since most of these cases are due to vertical transmission at or even before birth. One must also exclude teenagers, who may be having consensual sexual relations, and
GOLDENRING JM. Condylomata Acuminata: Still Usually a Sexually Transmitted Disease in Children. Am J Dis Child. 1991;145(6):600-601. doi:10.1001/archpedi.1991.02160060016007