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Is perianal dermatitis a sign of sexual abuse?

Three Part Question

In [young children with signs of perianal dermatitis] [increased likelihood] [of sexual abuse]?

Clinical Scenario

You have seen a toddler in clinic, and as a "by the way" on leaving the mother tells you that the child has a very red bottom and cries on defaecation although she is not constipated. On examination you see the classic signs of perianal dermatitis. You prescribe penicillin, and subsequent culture confirms streptococcal A infection. After clinic the staff grade doctor, who works with you and has expertise in child protection informs you that you should be considering sexual abuse as an issue. You decide to find out if there is an association between perianal dermatitis and child sexual abuse

Search Strategy

MEDLINE
Secondary sources: nil {perianal dermatitis.mp or exp anus disease/ or exp anus/ AND sex offenses/ or sexual abuse.mp}

Search Outcome

26 articles found, none relevant

Comment(s)

Nelson's textbook cites the consideration of child sexual abuse as an association with perianal dermatitis. A search of the literature does not appear to provide any primary evidencr to support this association.

Clinical Bottom Line

No evidence has been found to support or refute the association of perianal dermatitis and sexual abuse.