The natural history of condyloma in children

Background: Condyloma acuminatum, an infection caused by human papillomavir us (HPV), has become one of the most common sexually transmitted diseases. Correspondingly, anogenital warts are more frequently diagnosed in children . Twenty-five years ago a landmark prospective study showed that untreated common cutaneous warts in children spontaneously regress within 2 years in two thirds of cases, but a similar study of condyloma has not been publishe d. Several treatment options are available for condyloma in adults; none ha ve been studied or approved by the US Food and Drug Administration for trea tment of children. Objective: Our purpose was to review a cohort of children with condyloma to determine the natural history. Methods: Of 75 originally identified subjects with condyloma, 41 qualified for further retrospective or prospective evaluation, including distribution of lesions, duration of disease, gender, and treatment, if any. Results: Overall, condylomas in 31 of 41 children (76%) experienced resolut ion. Spontaneous resolution occurred within 5 years in 22 of 41 subjects (5 4%), including 6 of 8 (75%) who never received treatment, and 16 of 33 (49% ) in whom treatment failed. In 9 of 33 treated children (27%), resolution o ccurred during treatment. Girls presented three times more often than boys and resolution occurred comparatively more often in girls. Conclusion: Spontaneous resolution of pediatric condyloma occurred in more than half of our subjects. Nonintervention is a reasonable initial approach to managing venereal warts in children.