LAUSR

Pediatric anogenital condyloma acuminata (CA) is not infrequent, as increasing reports of its prevalence have demonstrated in recent years.1,2 However, periurethral CA is an unusual location for this virally transmitted disease and is exceptionally reported in medical literature. Human papilloma viruses (HPV) are the etiological causes for all types of warts, and variable modes of transmission both sexual and non-sexual, have been described in the pediatric population.1 Current treatments for anogenital CA in children prove challenging due to their young age, anatomic location and the high recurrence rates.1,3 Multiple therapeutic approaches range from topical treatments to more aggressive procedures, including surgery.4,5 We present an otherwise healthy, 2-year-old girl referred to our Department of Dermatology, with progressively increasing asymptomatic lesions in the diaper area of 2 months in duration. Physical examination showed multiple flesh-colored and brownish papules of 1--2 mm in diameter located in the vestibular and vulvar region in a symmetric V-shaped distribution as well as in the perianal region (Fig. 1(A)) Additionally, careful periurethral examination revealed an exophytic, reddish and papillomatous lesion of 1.2 cm in diameter (Fig. 2(A)) observing rich vascularity with dermoscopy. A clinical diagnosis of CA stage IV was established due to the extension of the lesions.2 PCR testing was performed for