Condyloma acuminata are warts that occur secondary to infection with the human papillomavirus (HPV), a double-stranded DNA that belongs to the family of Papillomaviridae. The incubation period from exposure to lesion development can last from months to years.

In children, HPV infections can present as common skin warts, anogenital warts, oral and laryngeal papillomas, and subclinical infections. HPV types 1, 2, 3, 4, 7, and 10 cause skin warts in children, with incidence peaking at ages 12-16. HPV types 6 and 11 account for most genital and oral warts, while types 16 and 18 cause both genital warts and genital malignancies. HPV infection causes oropharyngeal and anal cancers in patients of any sex and cervical, vaginal, and vulvar cancer in women.

Note: Childhood sexual abuse is a problem of epidemic proportions affecting children of all ages and of all economic and cultural backgrounds. A critical consideration for assessing condyloma acuminata in children is the determination of whether inoculation occurred as a result of sexual abuse. However, anogenital warts from HPV can also occur secondary to perinatal exposure, heteroinoculation (eg, from a caregiver changing diapers), autoinoculation (eg, from wart on the hand of the child), and indirect fomite transfer (eg, from shared towels). Large case series have found that about 3%-10% of anogenital warts in children are due to child sexual abuse.

Related topic: oral mucosal wart