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February 1992

Perianal Pseudoverrucous Papules and Nodules in Children

Author Affiliations

From the Departments of Dermatology (Drs Goldberg, Szaniawski, and Glassman) and Pediatrics (Division of Gastroenterology) (Dr Glassman), New York Medical College, Valhalla, NY; the Departments of Pediatrics and Dermatology, Medical College of Wisconsin, Milwaukee (Dr Esterly); the Department of Medicine, Division of Dermatology, University of Massachusetts Medical Center, Worcester (Drs Rothman and Cropley); and the Department of Dermatology, Massachusetts General Hospital, Boston (Dr Fallon).

Arch Dermatol. 1992;128(2):240-242. doi:10.1001/archderm.1992.01680120112014

• Background.—  Pseudoverrucous papules and nodules were originally described as a reaction to irritation in association with urostomies. These changes have not been described as occurring on the perianal skin or around colostomies.

Observations.—  Five children had remarkably similar-appearing papules and nodules of the perianal and suprapubic skin. The rash consisted of more than a dozen 2- to 8-mm shiny, smooth, red, moist, flat-topped, round lesions. This peculiar and striking reaction appears to be the result of encopresis or urinary incontinence. Biopsy specimens reveal reactive acanthosis or psoriasiform spongiotic dermatitis. The lesions regress when the irritating factor is removed.

Conclusions.—  Recognition of this entity is important because pseudoverrucous papules and nodules may mimic more serious dermatoses and unnecessary workup may be initiated. Although this reaction involving perianal skin has not been reported previously, we believe it is not uncommon.(Arch Dermatol. 1992;128:240-242)

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