Infantile perianal pyramidal protrusion (IPPP)/infantile perineal protrusion

IPPP is:
-Nontender pedunculated protrusion with a tongue-like tip
-Covered with smooth skin
-May appear red/pink, in fair skinned individuals
-Usually pyramidal
-Usually midline, anterior to the anus (posterior lesions can occur)
-Almost always in females
-May be associated with constipation and/or lichen sclerosis

Treatment:
-Typically not necessary
-Usually see recurrent swelling with eventual resolution

Differentiate IPPP from condyloma acuminata, trauma, skin tags, rectal prolapse, and granulomatous lesions of inflammatory bowel disease