Diagnosis of perianal pyramidal protrusion in infants

Infantile perianal pyramidal protrusion is characterized by a light pink to skin-colored soft tissue protrusion that is often midline and anterior [A1]to the anus. It most commonly occurs in young females and is relatively asymptomatic. Although biopsies are not routinely done, histopathology is relatively nonspecific and can appear similar to an acrochordon. The differential diagnosis is broad and clinical misdiagnosis as condyloma can lead to unnecessary accusations of child abuse. We report a case of perianal pyramidal protrusion that was originally biopsied owing to concern of condyloma acuminatum or molluscum. This case raises awareness of this diagnosis to help avoid unnecessary procedures and prevent emotional distress that could come for families with an inaccurate diagnosis of condyloma in young children.