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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.
Structured clinical question
In young children [patient] with signs of perianal dermatitis [risk factor] is there an increased likelihood of sexual abuse [outcome]?
Search strategy and outcome
Secondary sources: nil.
Medline: perianal dermatitis.mp or exp anus disease/ or exp anus/ AND sex offenses/ or sexual abuse.mp.
Search results—26 articles found, none relevant.
Nelson’s textbook1 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 evidence to support this association.
▸ Clinical bottom line
No evidence has been found to support or refute the association of perianal dermatitis and sexual abuse.