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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry

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Minerva Pediatrica 2011 August;63(4):319-25


language: English

Skin signs in child abuse and differential diagnosis

Oranje A. P. 1, Bilo R. A. C. 2

1 Department of Pediatrics, Pediatric Dermatology, Erasmus MC – Sophia Children’s Hospital and KinderHaven, Rotterdam, The Netherlands; 2 Section Forensic Pediatrics, Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, Netherlands


Child abuse has been recognized as a serious problem, of which the awareness in medical discipline but also in the general public has been increased since many years. The reporting of child abuse has therefore been increased during the last years. Also in politics it has been noted that the current situation around child abuse is alarming and the caring approach has many short-comings in early recognition and treatment. The skin is the most accessible organ of the human being. It is also the most frequently injured organ in child abuse. Skin abnormalities are visible to everyone. Therefore you need specific skills to correctly diagnose skin findings . The diagnosis of skin abnormalities in suspected child abuse is the work of experienced and dedicated specialists, e.g. pediatric dermatologists who are able to read the skin. Diagnostic errors can be prevented through close cooperation between forensic pediatrics, pediatric dermatology and pediatric radiology, but also other specialists should be consulted in difficult problematic clinical cases. Several skin disorders may mimic child abuse. Suspicion of child abuse must be approached just like every other medical problem in a child, namely based on expertise and multi-disciplinary cooperation and always supported by second opinion. In this review article skin signs of child abuse are stressed and the most common confusing dermatological disorders are illustrated.

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