Common skin and bleeding disorders that can potentially masquerade as child abuse

Abstract

Child abuse and neglect remains a major cause of morbidity and mortality among children worldwide. Over the last few decades, there has been growing research in the field of Child Abuse Pediatrics with greater recognition and research into potential diagnostic mimics of inflicted injury. This paper reviews some common skin findings and bleeding disorders that have features in common with child abuse. © 2015 Wiley Periodicals, Inc.

Lyme Disease Misinterpreted as Child Abuse

“…The case in this report is an example of misinterpretation of a constellation of findings including a fracture, swollen knee, and skin bruise. Christian and States and Patel and Butterfield also reported on several medical mimics and skin disorders that can mimic child abuse to the untrained reporter [ 22 , 23 ].…”

“…Disorders of collagen such as Ehler-Danlos syndrome (EDS), osteogenesis imperfecta (OI), and scurvy can lead to vessel fragility and easy bruising [ 25 – 27 ]. The skin is the largest and most exposed organ [ 23 ]. Cutaneous conditions such as congenital dermal melanocytosis (Mongolian spots), capillary hemangiomas, and arteriovenous malformations can masquerade as skin findings of suspected abuse [ 28 , 29 ].…”

“…Heritable hematological disorders such as Bernard-Soulier syndrome (BSS), Glanzmann thrombasthenia (GT), Von Willibrand disease (VWD), hemophilia disorders, and Wiskott-Aldrich syndrome have also been misconstrued for physical abuse [ 22 ]. Lichen sclerosus et atrophicus, a chronic inflammatory dermatitis affecting the anogenital region, can mimic findings of sexual abuse in prepubertal girls [ 23 ]. The use of over-the-counter moisturizers containing furocoumarin, when exposed to UV radiation, can cause a photooxidative reaction that can present as minor dermatitis to full-thickness scald burns mimicking abuse [ 30 ].…”

“…A prudent medical and family history, detailed physical examination and careful documentation can help differentiate physical abuse from child abuse mimics. Recognizing conditions that masquerade as abuse can improve the diagnostic yield and avoid adverse legal and psychosocial implications on the child, family, and society [ 23 ].…”

Cupping in dermatology: a critical review and update

“…However, it suggests that CAM practices such as cupping should be performed by trained professionals in an appropriate setting. Furthermore, it is necessary to increase cultural awareness and to take a comprehensive medical history in order to prevent false reports of child abuse (39).…”