ANOGENITAL WARTS IN PREPUBERTAL CHILDREN - PATHOGENESIS, HPV TYPING AND MANAGEMENT

The incidence of anogenital warts in prepubertal children is increasin g. Modes of transmission of human papillomavirus to the anogenital are a include perinatal, autoinoculation and heteroinoculation, sexual abu se and possibly indirect transmission via fomites. It was previously t hought that childhood sexual abuse was the most common mode of transmi ssion and human papillomavirus types 6 and 11 were most often detected . More recent studies, however, would suggest that perinatal infection and autoinoculation or heteroinoculation may be much more prevalent t han originally thought. It has been increasingly reported that human p apillomavirus type 2 is present in a significant proportion of cases. Assessment of children should be multidisciplinary and sexual abuse sh ould be considered in every case. Treatment modalities, although simil ar to adult disease, are particularly dependent on individual factors. Ln view of the as yet unknown risk of subsequent anogenital neoplasia it is recommended that individuals should have regular follow-up on a long-term basis.