Pediatric bowenoid papulosis: risks and management

A 34-month-old Haitian girl had a six-month history of asymptomatic vulvar papules. Histologic features and DNA probe studies were diagnostic of bowenoid papulosis. Resolution of the lesions was enhanced by cryotherapy. This is the third reported patient with prepubertal bowenoid papulosis. Sexual abuse should be suspected, but not assumed, in pediatric patients with this condition. Our patient had no evidence of sexual abuse. Bowenoid papulosis has been associated with cervical intraepithelial neoplasia and rarely with squamous cell carcinoma. Close gynecologic follow-up is recommended.