ETHICAL IMPLICATIONS IN THE DIAGNOSIS OF POTENTIALLY ORAL SEXUALLY TRANSMITTED LESIONS IN PEDIATRIC PATIENTS

Abstract

Oral squamous papilloma (OSP) is a benign proliferation of stratified squamous epithelium mostly associated with human papillomavirus (HPV) infection. Although OSP occurs predominantly in persons 30 to 50 years of age, it can have a juvenile onset affecting pediatric patients. Mode of transmission for HPV-related OSP in children is controversial. Various mechanisms have been reported as ingestion of viral particles through the birth canal, materno-fetal or perinatal transmission, autoinoculation or heteroinnoculation, and early sexual exposition. Diagnosis of OSP in pediatric patients poses the need for further investigation concerning the possibility of sexual abuse when other routes have been ruled out. We aimed to report 2 cases of OSP in 2 young girls, aged 8 and 11 years old, emphasizing the ethical aspects implicated in the diagnosis and management of a potential sexual transmission. Oral squamous papilloma (OSP) is a benign proliferation of stratified squamous epithelium mostly associated with human papillomavirus (HPV) infection. Although OSP occurs predominantly in persons 30 to 50 years of age, it can have a juvenile onset affecting pediatric patients. Mode of transmission for HPV-related OSP in children is controversial. Various mechanisms have been reported as ingestion of viral particles through the birth canal, materno-fetal or perinatal transmission, autoinoculation or heteroinnoculation, and early sexual exposition. Diagnosis of OSP in pediatric patients poses the need for further investigation concerning the possibility of sexual abuse when other routes have been ruled out. We aimed to report 2 cases of OSP in 2 young girls, aged 8 and 11 years old, emphasizing the ethical aspects implicated in the diagnosis and management of a potential sexual transmission.