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.

中文翻译：

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患有大小便失禁的 4 岁女孩的外阴周假性疣状丘疹和结节：病例报告

背景

尿布（刺激性）皮炎在儿科实践中很常见。在严重的情况下，不寻常的病变可能类似于其他外阴皮肤病或性传播感染。

案子

由于存在弥漫性外阴、会阴和肛周病变，一名患有大小便失禁的 4 岁女性难民被转诊进行法医学评估（关注儿童期性虐待）。评估和组织学与假性疣状丘疹和结节一致。在频繁更换尿布和使用保护性软膏后出现了解决方案。

讨论

假性疣状丘疹和结节是刺激性尿布皮炎的一种罕见并发症，外观多变。尿失禁或大便失禁是主要的危险因素，当出现非典型的生殖器或臀部病变时，应引起临床医生的怀疑。活检并非总是必要的，但在诊断不确定或怀疑儿童遭受性虐待时可能需要进行活检。