Condyloma acuminatum in a 2 1/2-year-old girl

Human papillomavirus infections in children: the potential role of maternal transmission

To date, more than 100 types of human papillomavirus (HPV) have been identified. In the past 20 years, there has been an increasing interest in HPVs because of their potential role in the pathogenesis of malignant tumors. HPV infections are known to affect predominantly adult, sexually active age groups, whereas skin warts, at various anatomic sites, are usually associated with younger individuals. The modes of viral transmission in children remain controversial, including perinatal transmission, auto- and hetero-inoculation, sexual abuse, and, possibly, indirect transmission via fomites. Recent studies on perinatal infection with HPV have been inconclusive. It is still unclear how frequently perinatal infection progresses to clinical lesions, whether genital, laryngeal, or oral. Conflicting reports have been published on the prevalence of HPV infections in children. The current consensus is, however, that newborn babies can be exposed to cervical HPV infection of the mother. The detection rate of HPV DNA in oral swabs of newborn babies varies from 4% to 87%. The concordance of HPV types detected in newborn babies and their mothers is in the range of 57% to 69%, indicating that the infants might acquire the HPV infection post-natally from a variety of sources. HPV antibodies have been detected in 10% to 57% of the children, and there is usually no correlation between seropositivity and the detection of HPV DNA in either the oral or the genital mucosa. There is also evidence that transmission in utero or post-natal acquisition is possible. The mode of in utero transmission remains unknown, but theoretically the virus could be acquired hematogenously, by semen at fertilization, or as an ascending infection in the mother. The understanding of viral transmission routes is important, particularly because several vaccination programs are being planned worldwide. The serologic response to HPV detected in different populations of young women or women at risk of cervical cancer might be due to genital infections, but the possibility that HPV infection has been acquired earlier in life through the oral mucosa or respiratory tract cannot be ruled out.

Sexually transmitted diseases in children: human papillomavirus infection

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Laryngeal papillomas: clinical aspects in a series of 231 patients

The records of 231 patients with laryngeal papillomas were reviewed. Considering age at onset and sex distribution, the patients were divided into four groups: juvenile solitary, juvenile multiple, adult solitary, and adult multiple papillomas. The main conclusions are (1) it is in general impossible to predict the course in individual cases, but solitary papillomas in adults follow a less severe course than do juvenile and adult multiple cases; (2) late recurrences (up to 42 years) makes it impossible to declare a patient cured; (3) there is no linkage between puberty and the disappearance of laryngeal papillomas; (4) a latent infection, acquired at or before birth, is unlikely to be responsible for adult papillomas.

Recurrent penile condylomata acuminata in a 17-month-old boy

Penile condyloma acuminatum is a rare pediatric entity. We report on a 17-month-old boy with penile and urethral condyloma acuminatum. The presence of cervical dysplasia in a histological setting suggestive of condyloma in his mother supports congenital acquisition of the disease. Histological and histochemical evidence for a viral etiology of the disease in the mother and patient is presented.

Condylomata acuminata in children: report of four cases

Four cases of condylomata acuminata in children (two boys, two girls) are reported. Three children had perianal warts and one vulvar warts. One of the four children had been sexually assaulted, but a history of sexual contact was absent in the other three. Surgical excision was undertaken in one case and the others responded well to the local application of 25% podophyllin in benzoin tincture compound. In the absence of sexual contact, a non-coital mode of transmission of infection could be a possibility.

Condyloma acuminatum in children

A case of extensive venereal warts in a nine-year-old female patient is presented. Transmission, pathology, and therapy are discussed.