Conditions which may be confused with abuse:
(1) bruises or lacerations
(2) fractures or blunt trauma
(3) burns or scalds
(4) anogenital lesions
(5) malnutrition or dehydration
(6) chronic wounds
(7) sedation (which may be confused with chemical restraint)
Differential diagnosis of bruises and lacerations:
(1) senile purpura
(2) steroid purpura
(3) senile skin laxity
(4) contact dermatitis
(5) coagulopathy secondary to medications or disease
(6) drug eruption
Differential diagnosis of fracture or blunt trauma:
(1) fracture secondary to osteoporosis
(2) fall injury
(3) intoxication
(4) hematoma associated with excessive anticoagulation
(5) impaired vision
Differential diagnosis of burns or scalds:
(1) toxic epidermal necrolysis
(2) fixed drug eruption
(3) contact dermatitis
Differential diagnosis of anogenital lesions:
(1) lichen sclerosis et atrophicus
(2) anal lesions associated with inflammatory bowel disease
(3) vaginitis or vaginal bleeding
(4) cystocele or rectocele
(5) fecal or urinary incontinence
Differential diagnosis of malnutrition or dehydration:
(1) gastrointestinal disorder (diarrhea, malabsorption)
(2) anorexia
(3) diabetes mellitus
(4) drug-induced diuresis
Differential diagnosis of chronic wounds:
(1) poor wound healing
(2) decubitus
(3) vascular ischemia
Differential diagnosis of sedation:
(1) adverse drug reaction
(2) decreased drug metabolism or excretion
