Ano-genital warts in children: Sexual abuse or not?

Child sexual abuse is a problem that affects many Americans. The diagnosis of sexual abuse is typically made on the basis of the child's history. Objective evidence of sexual abuse, including abnormal physical findings noted on physical examination or the presence of a sexually transmitted disease, are rare. Ano-genital warts are one of the most common sexually transmitted diseases found in adults. However, is the presence of ano-genital warts in children evidence of sexual abuse? The link between ano-genital warts and child sexual abuse requires an understanding of wart transmission and incubation period to properly interpret their significance. Ano-genital warts in children have serious medical, social, and legal implications. It is important that primary care providers have an understanding of the appearance, mode of transmission, and incubation period of human papilloma virus in children. Implications for practice will provide guidelines for diagnosing, evaluating, and properly managing ano-genital warts in children.