Outcome of CPS referral for sexual abuse in children with condylomata acuminata

The incidence of condylomata acuminata in children has increased dramatically.¹ Genital warts are associated with, but not specific for, sexual abuse and therefore present a dilemma for the physician. Clinicians frequently report presumed noncongenital cases to Child Protective Services (CPS) for further investigation. To determine the outcome of these cases, charts of 88 children with condylomata acuminata were reviewed. Sixty-four percent (56/88) of the children were referred to CPS for suspicion of child abuse or neglect; 26 of these 56 referrals were on the basis of genital warts alone. Sexual abuse was considered substantiated by CPS in 19% (5/26) of the children referred for warts alone. No consistent criteria seemed to lead to CPS substantiation of abuse. In the absence of other evidence of sexual abuse or neglect found on careful social, psychological, and medical evaluation, CPS referral is unlikely to be further able to differentiate abusive from nonabusive wart acquisition.