However, it should be recognized that fomite transmission is a possibility. The diagnosis of condyloma acuminata usually can be made by visual inspection. Obtaining tissue for biopsy necessitates a general anesthetic in children, so biopsy should be reserved for those cases in which the diagnosis is in question or operative treatment is planned. Treatment options for the clinic setting include application of podophyllin, trichloroacetic acid, or liquid nitrogen. However, these are all poorly tolerated by children because they are painful and require multiple applications.
Recent studies using topical, intralesional, or systemic interferon show similar results.
Genital herpes is uncommon in children. After the neonatal period, most cases result from sexual abuse, although infection is possible through autoinnoculation or close nonsexual contact. Vesicular, blistering lesions on the genitalia may also result from primary infection with the varicella-zoster virus. Direct fluorescent antibody testing should also be performed to differentiate between varicella and herpes simplex vims type I or type 2. When herpes is present, oral acyclovir may provide partial relief of symptoms.