Certain skin conditions can cause lesions that may be easily misinterpreted as abusive skin burns. A false accusation of child abuse can start a chain of events that can have a serious impact on the child, the family and the clinician.
Skin lesions in children that may confused with abusive injury:
(1) eczema
(2) bullous impetigo or other bullous skin disorder
(3) phytophotodermatitis
(4) contact dermatitis over the buttocks
(5) pruritic insect bites
(6) dermatographism
Pitfalls:
(1) a home environment considered "typical" for being abusive
(2) past history of abuse in the family
(3) rush to judgment without consideration of alternative explanations
Recommendations:
(1) Perform a complete history and physical examination that includes review of all allergies, medications, herbal remedies and environmental contacts.
(2) Consider alternative explanations for lesions that may superficially resemble abusive injuries.
(3) Consider having the patient evaluated by a dermatologist or getting a second opinion.
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