Cutaneous signs of child abuse

Swerdlin, Amy; Berkowitz, Carol D.; Craft, Noah

doi:10.1016/j.jaad.2007.06.001

Cited by 85 publications

(60 citation statements)

References 86 publications

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“…Another useful indicator is the form of bruises, which can indicate the shape of the object with which the injury was inflicted. Multiple bruises in clusters, in an unusual location, bruises located away from bony prominences, bruises in children younger than 9 months, bruises in various stages of healing, and further injury and damage may provide valuable information for distinguishing intentionally inflicted from accidental injury (18). There are many conditions that can mimic bruises, so we must think about the differential diagnosis of: Mongolian spots, blue mole, bleeding disorders, hypersensitivity vasculitis, infections, connective tissue diseases, erythema nodosum, phytophotodermatitis, hemangioma and incontinence of pigment (18).…”

Section: Bruisesmentioning

confidence: 99%

The physician's role in recognizing physical abuse of children

Mikulic¹,

Jurišić²

2013

Paediatr Today

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Physicians are in frequent and regular contact with children and families through regular check-ups of pregnant women, newborns, and children of preschool and school-age. Therefore, physicians are in a unique position to effectively detect risk or detect abuse and neglect in good time and initiate the process of providing assistance to protect the child and allow him/her recovery and further undisturbed development. This paper discusses definitions of physical abuse, risk factors and the most common forms of physical abuse, the differences between accidental and non-accidental injuries, and the protocol for professional action in cases of child abuse. Conclusion -Physical abuse of children is a common occurrence, and it carries a significant morbidity and mortality rate. Given that abuse often has a transgenerational character, early recognition and intervention with at-risk families have a preventive character in relation to the next generation.

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Section: Bruisesmentioning

confidence: 99%

The physician's role in recognizing physical abuse of children

Mikulic¹,

Jurišić²

2013

Paediatr Today

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“…9 Ecchymosis on the ears and genitalia is indicative of abuse, because these areas are rarely injured by accident. 20 Accidental abdominal ecchymoses are rare, due to the flexibility and muffling power of fat. When present, they indicate a strong impact and internal injuries should be investigated, as mortality rate reaches 50%.…”

Section: Ecchymosis and Differential Diagnosesmentioning

confidence: 99%

“…81 The diagnosis of sexual abuse and the protection of the child partly depend on the promptitude of the physician to consider abuse as a possibility. 82 Despite an increase in the number of cases, many doctors are not familiar with their recognition and don't know how to differentiate them from medical conditions that mimic sexual abuse 20 . Physical examination of the genitalia of boys and girls who have suffered sexual abuse reveals erythema, ecchymosis, excoriations and lacerations.…”

Section: Sexual Abuse and Differential Diagnosesmentioning

confidence: 99%

“…83 When sexual abuse is suspected, it is essential to remember that various dermatological diseases cause erythema, ulcers, friability or bleeding in the perigenital region. 20 Similarly to other lesions caused by trauma in more exposed areas of the body (ecchymoses and burns), lesions in this region can generate diagnostic questions and even undue accusations of abuse, as shown by the works listed in Chart 3.…”

Section: Sexual Abuse and Differential Diagnosesmentioning

confidence: 99%

“…Violent pulling can produce petechiae, edema of the hair scalp and acute hematoma 8 , with pain on palpation and irregular contours of localized hair loss. 77 Tinea capitis, traction alopecia, trichotillomania, loose anagen syndrome and alopecia areata are differential diagnoses 20 . Neglect is more common than overt physical violence and may eventually manifest itself as skin lesions 78 .…”

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confidence: 99%

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Violência contra a criança: indicadores dermatológicos e diagnósticos diferenciais

Gondim

Muñoz

Pagani

2011

An. Bras. Dermatol.

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Abstract:Reports of child abuse have increased significantly. The matter makes most physicians uncomfortable for two reasons: a) Little guidance or no training in recognizing the problem; b -Not understanding its true dimension. The most common form of child violence is physical abuse. The skin is the largest and frequently the most traumatized organ. Bruises and burns are the most visible signs. Physicians (pediatricians, general practitioners and dermatologists) are the first professionals to observe and recognize the signs of intentional injury. Dermatologists particularly, can help distinguish intentional injury from accidental, or from skin diseases that mimic maltreatment. Keywords: Burns; Contusions; Ecchymosis; Domestic violence; Sexual violence Resumo: As denúncias de abuso contra a criança têm sido frequentes e configuram grave problema de saúde pública. O tema é desconfortável para muitos médicos, seja pelo treinamento insuficiente, seja pelo desconhecimento das dimensões do problema. Uma das formas mais comuns de violência contra a criança é o abuso físico. Como órgão mais exposto e extenso, a pele é o alvo mais sujeito aos maustratos. Equimoses e queimaduras são os sinais mais visíveis. Médicos (pediatras, clínicos-gerais e dermatologistas) costumam ser os primeiros profissionais a observar e reconhecer sinais de lesões não acidentais ou intencionais. Os dermatologistas podem auxiliar na distinção entre lesões traumáticas intencionais, acidentais e doenças cutâneas que mimetizam maus-tratos.

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Hepatoerythropoietic Porphyria Misdiagnosed as Child Abuse

Cantatore-Francis

Cohen‐Pfeffer²,

Balwani³

et al. 2010

Arch Dermatol

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Background: Hepatoerythropoietic porphyria (HEP) is a rare autosomal recessive disorder resulting from the markedly deficient, but not absent, activity of the heme biosynthetic enzyme uroporphyrinogen decarboxylase (UROD). The disorder typically manifests during infancy or early childhood with extreme photosensitivity, skin fragility in sun-exposed areas, hypertrichosis, erythrodontia, and pink urine.Observations: Three siblings, offspring of parents of Puerto Rican and Dominican descent, had with excessive scarring on the face and dorsal aspect of the forearms, which initially led to the erroneous suspicion of child abuse. Although these lesions were photodistributed, overt photosensitivity had not been observed, with the exception of a single episode of blistering and ony-

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Cutaneous signs of child abuse

Cited by 85 publications

References 86 publications

The physician's role in recognizing physical abuse of children

The physician's role in recognizing physical abuse of children

Violência contra a criança: indicadores dermatológicos e diagnósticos diferenciais

Hepatoerythropoietic Porphyria Misdiagnosed as Child Abuse

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