Condylomata acuminata in the pediatric population

Article Abstract:

Condylomata acuminata (CA), or venereal warts, are caused by the human papillomavirus (HPV). The lesions are usually restricted to the region of the genitals and anus. Since CA is normally considered to be an adult disease, the frequency of occurrence in children may be due to an increased rate of infections in the adult population, increased early sexual activity in children, and sexual abuse of children. The potential of this virus to cause cancer has increased the concern about this disease in children. Lesion distribution in male children varies from that of the male adult, with greater involvement of the perianal area in children. Generally, there are less significant differences between female adults and female children. Seventy-four children, 43 female and 31 male, were included in this study. Viral transmission can occur during delivery (from an infected birth canal), during non-sexual family contact, or via sexual contact. The demographic history, clinical involvement, mode of infection, and therapy administered are detailed for each of the cases. The diagnosis of these venereal warts is based on their appearance as flesh-colored to purple papillomatous growths, particularly in the anogenital areas. Occasionally these lesions are smooth, flat and vesicle-like in adult women. Treatment is largely dependent on the size, location, and histology of the lesion and its potential for subsequent discomfort. Benign neglect has been utilized, since the natural history of these lesions suggests that some tend to disappear after three to five years. But this approach, considering the neoplastic potential of the virus, is not recommended. Podophyllin solutions, applied topically by the physician, may be of value. Other treatment modalities include cryotherapy (freezing), surgical removal, electrofulguration (tissue destruction with electrical current) and immunotherapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexually transmitted diseases, Care and treatment, Demographic aspects

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Comparative virologic studies of condylomata acuminata reveal a lack of dual infections with human papillomaviruses

Article Abstract:

Human papillomavirus (HPV) is the causative agent of condyloma acuminatum, which is characterized by the presence of warts on the skin and mucous membranes of the anus and genital (anogenital) organs. It is the most common of all viral sexually transmitted diseases and is often referred to as genital warts. In the majority of cases the warts are benign, but in a few cases they have been reported to transform and become malignant. There are at least 60 genetically different types of HPV (which contain different DNA), and approximately 20 of these can infect the genital organs. Three forms of HPV have been associated with condyloma acuminatum, type 6 (HPV-6), type 11 (HPV-11) and type 16 (HPV-16). To determine which types of HPV infection are most common in condyloma acuminatum, skin samples (biopsies) of genital warts were taken from 33 patients and analyzed for the presence of papillomavirus DNA (the genetic material) using the polymerase chain reaction. (This technique permits the identification of very small amounts of different types of DNA in a tissue sample.) The results revealed that 31 of the 33 biopsy samples were positive for HPV infection. In other words, 93.9 percent of the condyloma acuminatum samples contained HPV DNA: 22 of the samples contained HPV-6 DNA, 6 contained HPV-11 DNA, and 3 contained HPV-16 DNA. An HPV-infected skin sample never contained more than one type of HPV. The findings suggest that HPV-6 and HPV-11 are the most common types of HPV infection in condyloma acuminatum, and that multiple types of HPV infection do not occur simultaneously. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Papillomaviruses, Papillomavirus, DNA, Identification and classification, Polymerase chain reaction, Papillomavirus infections

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Urinary tract symptoms and urinary tract infection following sexual abuse

Article Abstract:

Increased frequency of urinary tract infections (UTI) has been associated with sexual activity among adolescents. UTI has been suggested as a possible indicator of sexual abuse. This study of 428 children ranging in age from 1 to 16 sought to determine the frequency of urinary symptoms following sexual abuse and the frequency of UTI in sexually abused children. It was found that 20 percent of the victims reported urinary symptoms; genitourinary symptoms including vaginal pain, bedwetting and urinary incontinence, painful urination, and increased urinary frequency were the most frequently complaints. UTI, however, was found in only two children. No significant relationship could be found between repeated abuse, trauma to the genitals, vaginal contact, or sex of the victim and genital-urinary symptoms. The results of this study do not support routine screening of patients who have been sexually abused but are without genitourinary symptoms. However, it is reasonable to obtain urine culture from sexually abused children who have GU symptoms. The specimen should be cultured specifically for Chlamydia trachomatis and Staphylococcus saprophyticus, both of which can cause genitourinary symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Injuries, Risk factors, Urinary tract infections, Genitourinary organs, Urogenital system

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