How to manage children with anogenital warts.

INTRODUCTION Children found to have anogenital warts (AGW) are usually brought in the first instance to their general practitioners (GPs), who may assess and manage the children themselves or refer them onto a specialist from one of several disciplines including paediatricians, dermatologists, paediatric surgeons or genitourinary medicine (GUM) physicians. In addition, if child sexual abuse (CSA) is considered advice may be sought from a sexual assault referral centre (SARC), and if so referral to children’s social care and police would be advised. The authors have all been contacted for advice regarding the management of these children and we have noted: ▸ Variable degrees of competence in the diagnosis of AGW. ▸ Unfamiliarity with paediatric genital examination. ▸ Unfamiliarity with the need to test for coexisting sexually transmitted infections (STIs) in children in whom CSA is suspected. ▸ Lack of up-to-date knowledge regarding appropriate tests including those for other STIs. ▸ Variable levels of concern about possible CSA and in some cases lack of awareness that this diagnosis requires consideration and what action is then required. To streamline this process, provide a framework for safeguarding evaluation and to ensure that all children are appropriately assessed, we developed a clinical algorithm for clinicians in any field supported by an appendix on sampling for STI screening for those less familiar with this.