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An 8-year-old Caucasian girl was referred with perineal bleeding of sudden onset during micturition. There was no history of trauma, fever or dysuria, but she had a history of constipation. Family history was unremarkable. Physical examination showed a prepubertal girl with a red ‘doughnut’-shaped lesion surrounding the urethral meatus (figure 1). Laboratory findings, including platelet count and coagulation, were normal. A vaginoscopy, performed using sedation, was negative. Swabs tested negative for sexually transmitted pathogens. A diagnosis of urethral …
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