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LETTER TO EDITOR
Year : 2018  |  Volume : 19  |  Issue : 4  |  Page : 382-383

Seeing beyond, mimicker of genital lesions and a personal view


Private Practice and Independent Researcher, Tripoli; Academic Title Holder at QU, Health Professional; Volunteer Writer, DermNet NZ's, Zealand

Date of Web Publication28-Sep-2018

Correspondence Address:
Dr. Ebtisam Elghblawi
Private Practice, Dermatology OPD, Academia Title for Health Professional, Independent Researcher

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpd.IJPD_17_17

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How to cite this article:
Elghblawi E. Seeing beyond, mimicker of genital lesions and a personal view. Indian J Paediatr Dermatol 2018;19:382-3

How to cite this URL:
Elghblawi E. Seeing beyond, mimicker of genital lesions and a personal view. Indian J Paediatr Dermatol [serial online] 2018 [cited 2021 Aug 5];19:382-3. Available from: https://www.ijpd.in/text.asp?2018/19/4/382/211806



Sir,

A 4-year-old skin type VI Libyan girl presented with multiple increasing hard skin-colored lesions on the perianal area that developed one year earlier to the presentation.

They are six in number and are 0.5–1 mm in diameter. Dermatoscopic examination showed a white structureless highly attenuated with polarized specific multiple white lines in reticular arrangement (crossing over) with no other specific finding [Figure 1].
Figure 1: Six nodular skin coloured lesions and a dermatoscopic view [Copyright: ©2017 Elghblawi]

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The lesion was excised, and histopathological examination confirmed a fibrous mass skin lesion with focal epidermal hyperplasia with hyperkeratosis and focal marked acanthosis.

Common dermatoscopic feature of molluscum contagiosum (MC) is confusing.

In my case, the presence of multiple nodular skin lesions around the anus can be mimicking to MC, genital warts, and child abuse.

In particular, in early stages, the lesion could be confusing and could be increasing secondary to external injury and trauma which predispose to autoinoculation and kobner phenomena. It has been stated that children who wear diapers due to chronic urinary incontinence are prone more to such type of chronic irritation and thus dermatitis.[1] However, diaper-related skin changes were excluded as the girl is not using diaper anymore since three years as the mother affirmed.

In this patient, anogenital warts had to be ruled out; nonetheless, many skin diseases must be considered in the differential diagnosis of these misunderstood skin-colored lesions.[2]

In such cases, dermatoscope and biopsy must be supplemented by clinical findings to achieve and reach acceptable diagnosis accuracy.

Appreciation of this entity is important because pseudoverrucous papules and nodules may imitate more serious dermatoses, and needless workup may be initiated. Even though this reaction involving perianal skin has not been reported previously, I still believe it is not scarce.

A proper clinical inspection with a precise meticulous history should be enough in a young patient to exclude other pathologies, even without histology or perhaps viral screening.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Dandale A, Dhurat R, Ghate S. Perianal pseudoverrucous papules and nodules. Indian J Sex Transm Dis 2013;34:44-6.  Back to cited text no. 1
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2.
Coppo P, Salomone R. Pseudoverrucous papules: An aspect of incontinence in children. J Eur Acad Dermatol Venereol 2002;16:409-10.  Back to cited text no. 2
    


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