Cruces M J, De La Torre C, Losada A, Ocampo C, García-Doval I
Department of Dermatology, Hospital Provincial de Pontevedra, Spain.
Arch Dermatol. 1998 Sep;134(9):1118-20. doi: 10.1001/archderm.134.9.1118.
A perineal infantile lesion previously described as "skin tag/fold" had recently been named infantile perianal pyramidal protrusion. It appears on the perineal median raphe of girls as a pyramidal soft tissue swelling, covered by smooth, red or rose-colored skin. Its pathogenesis is unknown. As in the case of other perianal lesions, knowledge about it is important, as concern about signs of child abuse grows.
Four girls, 2 of them sisters, with infantile perianal pyramidal protrusion were studied. Three of these girls showed subtle clinical evidence of classic lichen sclerosus et atrophicus on first examination. The other girl developed vulvar lesions of lichen sclerosus et atrophicus months after the diagnosis of infantile perianal pyramidal protrusion. All 4 protrusions disclosed histopathological findings diagnostic of lichen sclerosus et atrophicus.
Infantile perianal pyramidal protrusion is, at least in some patients, a peculiar form of lichen sclerosus et atrophicus that can precede other, more characteristic manifestations. We suggest changing the name to the more precise infantile perineal protrusion. Knowledge of this hitherto unrecognized clinical form of lichen sclerosus et atrophicus can help to explain anogenital symptoms and avoid its misinterpretation as a sign of sexual abuse.
一种先前被描述为“皮赘/皮褶”的会阴婴儿期病变最近被命名为婴儿肛周锥体样隆起。它表现为女孩会阴正中缝处的锥体样软组织肿胀，表面覆盖光滑、红色或玫瑰色皮肤。其发病机制尚不清楚。与其他肛周病变一样，随着对虐待儿童迹象关注度的增加，了解这种病变很重要。
对4名患有婴儿肛周锥体样隆起的女孩进行了研究，其中2名是姐妹。这4名女孩中有3名在初次检查时显示出典型硬化性萎缩性苔藓的细微临床证据。另一名女孩在婴儿肛周锥体样隆起诊断数月后出现了硬化性萎缩性苔藓的外阴病变。所有4个隆起均显示出硬化性萎缩性苔藓的组织病理学诊断结果。
婴儿肛周锥体样隆起，至少在某些患者中，是硬化性萎缩性苔藓的一种特殊形式，可先于其他更具特征性的表现出现。我们建议将其名称改为更准确的婴儿会阴隆起。了解这种迄今未被认识的硬化性萎缩性苔藓临床形式有助于解释肛门生殖器症状，并避免将其误解为性虐待迹象。
