Dermatologists and pediatricians are experiencing an epidemic of condyloma acuminata in both adults and children.1-4 The presentation of a child with anogenital wart disease raises many issues and all too often, great anxiety. Not only does the clinician face the often difficult task of treating these recalcitrant warts, but the issue of sexual child abuse must be seriously considered. Dermatologists are often consulted as experts by legal authorities regarding the possibility of sexual child abuse and, unfortunately, accurate, reliable information regarding human papillomavirus (HPV) biology in the pediatric age group has been lacking. This confusion and ignorance may impede the appropriate investigation of a family by police, legal, and psychology/ social work professionals. Though the physician is often motivated to report a case of suspected sexual child abuse, there may be a reluctance to do so because of the erroneous belief that a large percentage of anogenital warts in children are transmitted by nonvenereal routes. Misconceptions exist regarding the epidemiology of anogenital warts in adults, See also p 1129. and very little information has been gathered to date regarding this problem in children. Therefore, the dermatologist often "hedges" when answering the queries of police, lawyers, psychologists, social work¬ ers, and the courts. In my own experience, this can result in the reluctance of the courts to make certain critical decisions regarding the child in question, because the suspicion of sexual abuse cannot be "proven." More clinicians are becoming aware of the associ¬ ation between certain HPV types and genital neopla-