Genital warts in a neonate as a possible sign of abuse

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A six-month-old boy presented with a penile growth that first appeared within weeks of his birth. His mother reported that since then, the asymptomatic lesion had grown and become more verrucous. No warmth or tenderness was associated with the growth. In a letter sent along with the patient, the referring pediatrician expressed concern about whether the presence of anogenital warts in a prepubescent child is evidence of sexual abuse. Should he report the finding to child protective services?

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