THERAPY IN PRACTICE Perianal Lesions in Children: An Updated Review Michelle Xu 1 • Hannah Liu 1 • Sharon Glick 1 • Amor Khachemoune 1,2 Ó Springer International Publishing Switzerland 2017 Abstract Perianal lesions in children are common reasons for dermatology clinic visits and a well-defined approach to diagnosis and management is helpful to the practicing clinician. In this article, we review and update various etiologies of perianal lesions in the pediatric population, including infectious, papulosquamous, vascular, and neo- plastic. We provide a standard initial approach to diagnosis and updates on current management. Infectious etiologies of perianal lesions discussed in this article include fungal, bacterial, parasitic, and viral. Perianal papulosquamous lesions often encountered in children, and discussed in this article, include acrodermatitis enteropathica, psoriasis, contact dermatitis, and many others. We also discuss the diagnosis and management of other entities including infantile hemangiomas, Langerhans cell histiocytosis, and fibrous hamartoma of infancy. Key Points Perianal lesions in the pediatric population require a standardized approach to diagnosis and management. It is important to involve a dermatologist for rare perianal cutaneous lesions, and for those that do not respond to standard therapies to guide diagnosis and management. Dermatologists must maintain a high level of suspicion for child abuse in patients presenting with perianal lesions. 1 Introduction Pediatric perianal lesions are commonly encountered in dermatology clinics. This article reviews the various eti- ologies of these perianal lesions including infectious, vas- cular, and neoplastic with a goal of providing a standardized initial approach to diagnosis and manage- ment. The lesions discussed are commonly found in chil- dren from 0 to 14 years of age with occasional perianal cutaneous involvement in teenagers from 15 to 17 years of age. PubMed was the primary database used for the liter- ature search with the inclusion criteria of English text, abstracts containing one or more of the keywords, peer- reviewed journals, and articles from 1994 to present. Exclusion criteria included non-peer-reviewed journals and studies older than 1994. & Amor Khachemoune amorkh@gmail.com 1 Department of Dermatology, State University of New York Downstate Medical Center, 10 West, 800 Poly Place, Brooklyn, NY 11203, USA 2 Veterans Affairs Medical Center, Brooklyn, NY, USA Am J Clin Dermatol DOI 10.1007/s40257-017-0259-z