Available online 4 October 2023

A 13-year-old presented with a genital lesion, which helped in guiding a diagnosis of child sexual abuse (CSA). The patient disclosed unprotected penile-vaginal penetration by a 20-year-old male neighbor. On exam, her left labia minora had a single 2 centimeter hypopigmented fleshy non-tender mass and laboratory studies revealed positive Treponemal IgG IgM antibody (>8) and rapid plasma reagin (RPR) titer of 1:128, indicating syphilis infection. Given the resolution of the labial mass with treatment of syphilis, this lesion was most consistent with condyloma lata.

Genital exams are an important component of pediatric evaluations. Condyloma lata can vary in appearance (papules, nodules, or wart-like lesions) and color and may present as a single lesion or multiple lesions. Our patient had one 2 centimeter lesion, and therefore clinicians should assume that an anogenital lesion is condyloma lata in the setting of positive syphilis testing.

syphilis

child abuse pediatrics

infectious disease

condyloma lata

© 2023 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.