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Background: Ano-genital warts (HPV) or condiloma acuminata is one of the most common sexually transmitted diseases of the ano-genital tract in sexually active adults. The incident of ano-genital warts in children has increased dramatically since the last decades. This increase seen in children is most likely due to the increasing ano-genital infections in adults. While sexual transmission is being recognized as a possibility in children, other possible modes of transmission have been described. Recognizing the variability of modes of transmission, especially the nonsexual mode of HPV infection, is very significant in the pediatric population.
Case 1: A 7 years old girl was referred from dermatology clinic. She was first diagnosed as having ano-genital condiloma 4years ago. Her family history of HPV infection was not remarkable.
Case 2: A 5 years old girl; firstly they referred to dermatology clinic after her paternal grandmother had recognize genital lesion at the age of four. Last year her father had been diagnosed to have genital condiloma; her mother had warts in her in fingers almost ten years ago, and her parental grandmother had a history of ano-genital warts. There was no significant evidence of sexual abuse in each two cases.
Discussion: In the past, the finding of HPV ano-genital infection caused the medical providers to pursue an investigation for sexual abuse. However, in the last decade there has been increasing evidence of nonsexual transmission of HPV in this population. The acquisition of HPV can occur in a variety of ways. Ano-genital warts are alone not an indicator for sexual abuse investigation and all aspects of the history, physical examination and interview are necessary.