We describe a case of severe perianal Crohn’s disease masquerading as perianal warts in a non-sexually active adolescent girl presenting to a genitourinary medicine clinic. Perianal Crohn’s disease should always be suspected in children and adolescents presenting with perianal skin manifestations to any healthcare settings in order to avoid delay in diagnosis and treatment of this chronic disabling condition. A 13 year old, white girl initially presented to her general practitioner (GP) with a 3 month history of constipation and pain during defaecation. She was embarrassed by her condition, and was therefore not examined by her GP. She was treated with Xyloproct ointment and laxatives, with no improvement. Three days later, she presented …