The natural history of condyloma in children

Condyloma acuminatum, an infection caused by human papillomavirus (HPV), has become one of the most common sexually transmitted diseases. Correspondingly, anogenital warts are more frequently diagnosed in children. Twenty-five years ago a landmark prospective study showed that untreated common cutaneous warts in children spontaneously regress within 2 years in two thirds of cases, but a similar study of condyloma has not been published. Several treatment options are available for condyloma in adults; none have been studied or approved by the US Food and Drug Administration for treatment of children.

Our purpose was to review a cohort of children with condyloma to determine the natural history.

Of 75 originally identified subjects with condyloma, 41 qualified for further retrospective or prospective evaluation, including distribution of lesions, duration of disease, gender, and treatment, if any.

Overall, condylomas in 31 of 41 children (76%) experienced resolution. Spontaneous resolution occurred within 5 years in 22 of 41 subjects (54%), including 6 of 8 (75%) who never received treatment, and 16 of 33 (49%) in whom treatment failed. In 9 of 33 treated children (27%), resolution occurred during treatment. Girls presented three times more often than boys and resolution occurred comparatively more often in girls.

Spontaneous resolution of pediatric condyloma occurred in more than half of our subjects. Nonintervention is a reasonable initial approach to managing venereal warts in children.