ABSTRACT
Background
Diaper (irritative) dermatitis is commonly encountered in pediatric practice. In severe
cases, unusual lesions could mimic other vulvar dermatoses or sexually transmitted
infections.
Case
A 4-year-old female refugee with urinary and fecal incontinence was referred for medicolegal
evaluation (concern for childhood sexual abuse) due to presence of diffuse vulvar,
perineal, and perianal lesions. Evaluation and histology were consistent with pseudoverrucous
papules and nodules. Resolution occurred following frequent diaper changes and application
of a protective ointment.
Discussion
Pseudoverrucous papules and nodules are a rare complication of irritative diaper dermatitis
with variable appearance. Urinary or fecal incontinence are primary risk factors that
should raise suspicion among clinicians when atypical genital or buttocks lesions
appear. Biopsy is not always necessary but could be warranted when the diagnosis is
uncertain or if childhood sexual abuse is suspected.
Key Words
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Article info
Publication history
Published online: July 08, 2022
Accepted:
July 5,
2022
Received in revised form:
May 31,
2022
Received:
March 9,
2022
Identification
Copyright
© 2022 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
