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Online ISSN 1827-1677
Procaccianti P., Argo A., Todaro P., Santamaria F.
Università degli Studi - Palermo, Istituto di Medicina Legale e delle Assicurazioni
Insurance medicine has been concerned with disfigurement since Gerin’s time. More recently objective criteria have been established for the assessment of the disfigurement caused by scarring and are now widely employed. The guide to the assessment of permanent biological damage published by SIMLA represents a further contribution to the classification of aesthetic dysfunction. However the assessment of disfigurement in minors poses particular problems in a sector of insurance medicine where considerable uncertainty already reigns. The present paper illustrates the particular character of such assessments by means of a clinical case history of a minor who had been badly disfigured giving details of the approach to assessment which was based on authoritative indications in the literature. It is claimed that in attempting to achieve an objective view on the complex question of disfigurement in minors, it is essential that in addition to the views of a plastic surgeons, it is necessary to adopt a systematic approach to the possible psychological consequences of the disfigurement with the aid of a child psychologist and/or neuropsychiatrist. Finally, the paper emphasises the need to consider the possible impact of the disfigurement on the child’s future employment prospects.