Localized vulvar pemphigoid in a child misdiagnosed as sexual abuse.

BACKGROUND

Various primary dermatoses can affect the vulva of children and be misdiagnosed as child abuse, with devastating social consequences.

OBSERVATION: A 3-year-old girl with vulvar erosions was removed from her parent's care after a pediatrician and gynecologist diagnosed child abuse. Histopathologic and immunofluorescence studies were consistent with vulvar pemphigoid.

CONCLUSION

Localized pemphigoid should be added to the differential diagnosis of vulvar lesions. Dermatologists, pediatricians, and gynecologists should be familiar with nonvenereal diseases that can exclusively affect this area. The dermatologist's expertise is particularly valuable in differentiating between primary diseases and sexual abuse.