Since sexual abuse is all too common, you will need to recognize genital abnormalities associated with sexual abuse. These include:
(A) Acute hemorrhage and ecchymoses of tissues (10-mo old)
(B) Erythema and superficial abrasions to the labia minora (5-yr old)
(C) Healed interruption of hymenal membrane at 9 o'clock (4-yr old)
(D) Narrowed posterior ring continuous with floor of vagina (12-yr old)
(E) Copious vaginal discharge and erythema (9-yr old)
(F) Extensive condylomata around the anus (2-yr old)
(Sources of photos: Ambiguous Genitalia—McMillan J, DeAngelis C, Feigin R Warshaw J: Oski's Pediatrics, 3rd ed., Philadelphia, Lippincott Williams & Wilkins, 1999; Sexual Abuse, (A), (B), (C), (D), (E), (F)—Reece R Ludwig S (eds.): Child Abuse Medical Diagnosis and Management, 2nd ed., Philadelphia, Lippincott Williams & Wilkins, 2001.)
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