Indian J Pediatr. 2024 Oct 19. doi: 10.1007/s12098-024-05284-x. Online ahead of print.
ABSTRACT
A 7-y-old girl presented to the pediatric department with a two-week history of a skin lesion in the anogenital region. She appeared well-nourished, quiet, afebrile; vitals and her systemic examination was normal. Examination revealed a greyish white wart-like perianal lesion, unusual for her age. Further history revealed the child had become withdrawn, avoiding play recently, and had oral and vaginal ulcers a month earlier without treatment. These findings raised suspicion of sexual abuse. Investigations confirmed positive VDRL (1:64 titres), positive TPHA, and negative results for her parents’ TPHA and HIV. A medicolegal case was registered, involving child welfare services and police. A psychiatrist diagnosed post-traumatic stress disorder and recommended counselling. Treatment with a single dose of intramuscular Benzathine penicillin led to improvement, with VDRL titres decreasing to 1:8 and complete resolution of the lesion after 3 months. Pediatricians are pivotal in identifying and managing child sexual abuse cases promptly.
PMID:39425823 | DOI:10.1007/s12098-024-05284-x
