[Condylomas in children]

A case of reccuring giant condyloma of vulva in infant without sexual abuse successfully treated with electrocoagulation in Benin

We report here a case of giant vulval condyloma in a two-year-old infant infected by her “baby sitter” without sexual abuse. Treated by surgical excision coupled with electrocoagulation, it was noted a rapid recurrence two weeks after treatment requiring a second electrocoagulation session. More than a year later, no lesion was noted, thus demonstrating therapeutic success. The unavailability of imiquimod in our context requires a systematic use of invasive treatment regardless of the age of the patient.

[Treatment of pediatric genital condyloma]

Condyloma, also known as venereal warts, are caused by human papillomavirus (HPV). Conventional wart therapies destroy infected keratinocytes rather than directly inhibiting viral infection or replication. No available drug therapy effectively eliminates HPV. Treatments are often disappointing for the patient, the family and the physician due to the duration of the disease and the frequency of recurrences in spite of treatment.

[Carbon dioxide laser therapy for anogenital warts in children]

BACKGROUND

Management of anogenital condylomas in children can be delicate especially in the event of profuse lesions and raises the issue of identification of the mode of contamination.

PATIENTS AND METHODS

The dossiers of all children referred to the laser unit of "La Conception" University Teaching Hospital in Marseille between 1995 and 2005 for treatment of profuse anogenital condylomas were studied retrospectively. The main objective was to evaluate the efficacy and tolerability of CO2 laser treatment for anogenital condylomas. The secondary objective was to invstigate the mode of contamination.

RESULTS

Seventeen children aged 2-11 years were treated. All were examined in routine fashion, as were their parents and siblings, for signs of PVH infection and sexual abuse. Laser was performed by the same operator under general anaesthesia. For all of these children, healing was rapid and without complication or functional sequelae. Two children were lost to follow-up. Ten children (66.7% of the treated children) presented no recurrence after only one session of CO2 laser. Vertical transmission was diagnosed for 6 children and horizontal transmission for 7 children. For 4 children, the mode of contamination remained unknown. No cases of sexual abuse were proven.

CONCLUSION

Due to its painless nature, rapid healing, low rate of complications and recurrence, and minimal risk of scarring, CO2 laser is an effective treatment for the management of profuse anogenital condylomas in children. Vertical transmission is the most frequent mode of contamination and sexual abuse remains rare, although clinicians must keep this possibility in mind.