To the Editor.—
In the article by Cohen et al1 on anogenital warts in children, the authors conclude that most of their children were at low risk for sexual abuse. Only eight of 73 children examined by them qualified for "suspected or documented abuse" after their evaluation.The first problem with the article is that the criteria for sexual abuse are not detailed. Instead, subjective criteria are employed. Another major problem with their study is that only half of the fathers were available for examination. Since adult men are the most common instigators of sexual abuse in children, examining only half of the fathers provides insufficient evidence to conclude that parental abuse is absent. The role of caretakers and babysitters in the family is also important in determining sexual abuse. However, we are not told the extent to which this avenue was explored, only that such caretakers were
Kanzler MH. Anogenital Warts in Children. Arch Dermatol. 1991;127(7):1063–1064. doi:10.1001/archderm.1991.01680060139023
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