A 7-year old girl brought by her parents with two-week history of growth in the perianal region. On examination there was a greyish white fleshy plaque around the anal margin. A positive history of sexual abuse could not be elicited from the child or her parents. Dark-field examination of the lesion was positive for Treponema pallidum, rapid plasma reagin(RPR) was reactive in titre of 1:32 and treponema pallidum haemaglutination assay (TPHA) was positive. A diagnosis of secondary syphilis with condyloma lata was made. The child was treated with appropriate dose of benzathine penicillin and the lesion resolved completely. RPR titre found decreasing during follow-up. Arriving at the diagnosis of condyloma lata was relatively simple but establishing the mode of transmission was difficult eventhough, exclusively child sexual abuse was suspected.
