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October 1987

Condylomata Acuminata in the Evaluation of Child Sexual Abuse-Reply

Author Affiliations

Department of Dermatology The Johns Hopkins Medical Institutions 600 N Wolfe St Baltimore, MD 21205

Arch Dermatol. 1987;123(10):1266. doi:10.1001/archderm.1987.01660340026004

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In Reply.—  In general, I agree with Dr Goldenring's comments. I would reiterate that the current study was undertaken to clarify the epidemiology of condylomata acuminata in children. As was noted in our article, there are many contradictory reports regarding this subject in the literature.Dr Goldenring is a pediatrician and has voiced his concerns well. From the dermatologist's point of view, I would like to urge caution in the "presumption" of sexual transmission when first seeing a child with genital lesions. As Dr Goldenring pointed out in one of the cases referred to in his letter, the actual diagnosis may not always concur with the initial clinical impression. Skin tags, neurofibromas, nevi, and other benign growths may simulate condylomata acuminata. First and foremost, a correct diagnosis must be made. Following that, the usual evaluation for children with a sexually transmitted disease should be undertaken.On data support the direct transmission of

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