RESUMO
A 2-year-old girl presented with a month history of a tender, erythematous pyramidal protrusion on the perineum, anterior to the anus. She had suffered painful defecation due to the protrusion, but had no history of constipation. The family history was negative, and physical examination showed no evidence of associated anal fissuring or skin atrophy. Histological examination revealed epidermal hyperplasia, dermal edema, and hemorrhage with inflammatory cell infiltration. The patient was treated with a CO2 laser to relieve painful defecation. Infantile perianal pyramidal protrusion (IPPP) is characterized by a solitary protrusion observed in the perineal and perianal area. Since IPPP is predominantly observed in female children in the perineal area, it can be misdiagnosed as sexual abuse, anogenital warts, or hemorrhoids. The disease is generally benign and may resolve spontaneously, with the exception of the lichen sclerosus-associated type. Physicians should be aware of IPPP to make an accurate diagnosis.