Child abuse (skin signs)

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"Child Abuse Definition: mistreatment of a child by a parent or guardian including neglect, beating, and sexual molestation." Since there are different types of abuse it can be difficult to recognize if abuse is actually taking place. Child Abuse is a serious matter and there are different skin signs to show that a child is suffering from abuse.The abuse can also include sexual and neglect that will also show skin marks.

Injuries to the skin are amongst the most common indicators that a child has been physically abused. These injuries include burns and bruises. While also looking at the different types of abuse that occur such as neglect, sexual abuse that can also leave signs on the skin that the child has been recently or previously abused. Intentionally inflicted injuries are often in characteristic locations, patterns, and shapes that help differentiate them from accidental injury.

Signs of child abuse are just not physical, there is also behavioral signs that a child can have that people could recongzie that the child is suffering from abuse even if there is not skin signs that are hidden from the eye. The ability to recognize these types of inflicted injuries, as well as the various differential diagnoses--medical conditions that mimic cutaneous signs of abuse--is key to child protection.

Video Child abuse (skin signs)

Signs of Physical Abuse in a Child

Physical:

• Injuries to a newborn
• Noticeable and serious injuries
• Injuries healing at different times
• Injuries all over the body
• Unexplained injuries
• Injuries explained that do not make sense
• "Distinctive shape"
• Consistency, timing; such as after weekends, vacations, school absences)

Behavioral:

• Aggressive tendencies
• Fearful of parents or other adults
• "Fear, withdrawal, depression, anxiety"
• "Wears long sleeves out of season"
• Art and fantasies tend to be violent
• "Nightmares, insomnia"
• Discusses harsh discipline and injuries
• Trouble maturing, hard dealing with emotion and behavior, and acting out
• Low self confidence and continually bringing themselves down

Maps Child abuse (skin signs)

Different Skin Signs of Abuse

Bruises

Physical abuse can be diagnosed by bruising, which the bruises are in different suspicious locations of the body and are healing at different times. Accidental bruising is caused from trauma which the bruises generally are in locations that tend to be more in bony areas of the body for example: knees, elbows, shins, and foreheads. Whereas intentional bruises tend to occur in softer areas of the body such as: thighs, abdomen, buttocks, cheeks, and neck.

"Bruising of the skin occurs after blunt trauma, which disrupts underlying blood vessels and causes leaking and collection of blood in the dermal layers."

Types of Bruises

• Tramline bruise: two linear shaped bruises separated by a linear area of relatively unbruised skin, which results from being struck with a rectangular or cylindrical object.
• Linear bruising: The slap of an open hand may leave parallel linear bruises on the cheek or elsewhere, bruises may also be caused by objects such as a stick, rod, etc.
• Pinch mark: two oval shaped bruises, with one bruise--caused by the thumb--larger than the other, separated by an area of relatively unbruised skin. Depending on the amount of pressure applied, a hematoma may be present within the area between the two bruises. Curvilinear lacerations caused by fingernails may be present in one or both bruised areas. Typically these occur in smaller pinch marks where the skin is pinched between the fingernails.
• Fingertip bruising caused by grabbing or squeezing the flesh appear as oval shaped bruises with the bruise caused by the thumb some distance away. Not all of the fingers may leave a bruise as a result of uneven pressure being applied.

Thermal burns

Burning is a very traumatic form of abuse for a child. Cigarette burns are typical burns to look for when a child has a unexplained or weirdly explained burn mark on them, this type of burn is generally rounded ulcers or erosions.

A child can also suffer from branding as another type of burning abuse. The branding may occur with objects such as spoons or forks that has been heated up and placed on the child's skin, the object may leave a mark in the shape of the object that was placed on the skin.

Immersion burns are burns that are caused by submerging a child's buttocks or other body parts into scalding hot water. They tend to be sharply demarcated in a "a glove and stocking distribution", with a uniform depth of burn. "Donut-type sparing" occurs when the child's buttocks is pressed to the bottom of the tub while the neighboring immersed skin is burned.

Bites

Human bites leaves a distinguished mark on a child so it is very important to take a picture of the mark to have a reference of the abuse. "If the distance between the marks from the canine teeth is greater than 3 cm, the perpetrator possesses adult dentition." Human bites gravitate towards a crush injury rather than actually puncturing the skin.

Animal bites may be recognized by smaller puncture marks and different spacing on the skin.

Binding Injuries

"Binding injuries occur when the wrists and ankles are tied. Acute injuries may present with soft-tissue swelling, redness, warmth or abrasions around the wrists and ankles. Older, healed injuries may present with post-inflammatory pigment change circumferentially around the wrists or ankles."

Signs of Neglect

Physical neglect can be recognized with a sequence of poor hygiene, malnutrition, and occasionally over looked illnesses such as scabies and head lice. A child that is neglected that did not receive the proper shots as a child may develop infections or illnesses such as measles.

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Location

• Accidental bruises tend to occur on the ankles, shins, hips, lower arms, elbows, and under the chin.
• Inflicted bruises are often found on the upper arms, buttocks, face, neck, and ears. Bruising to the soft tissue areas of the cheek, abdomen, upper thighs, and genitalia strongly suggest of abuse.

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Differential Diagnosis

The dermatologists responsibility is to be able to determine different skin lesions that could have been caused from child abuse. Bruises, burns, bites, binding injuries, and neglect are all different forms of abuse that a dermatologists should be able to recognize when examining a child. One of the most common markings that physicians that are not dermatologists miss is; Mongolian spots which are sometimes confused with bruises. The Mongolian spots occur and or commonly found on the buttocks and back, unlike bruises thesis spots are not painful and do not change over days or weeks.

A study of coagulation (clotting) should take place in children with several bruises in suspicious areas to determine that it is not something with their blood before ruling on child abuse. Different types of cancer such as leukemia and idiopathic thrombocytopenia purport should be consider when examining a child with multiple bruises on their body. This could be consider a fault of visual culture because the person expressing child abuse does not know the medical history of the child and jumping to conclusions because the child does have different bruises healing at different times which is one of the many forms of recognizing physical skin signs of child abuse.

"Certain forms of vasculitis that typically present in childhood (eg, Schönlein-Henoch syndrome and acute hemorrhagic edema of infancy) can occasionally cause purple erythematous, edematous plaques that can mimic inflicted injuries. Children with Schönlein-Henoch syndrome often have lesions on the legs and buttocks, frequently in association with a previous infection and abdominal and joint pain."

These different diagnoses could people to believe that there is signs of child abuse present because of visual culture leading to people assume the child is being abused before actually knowing what is occurring with the child medically. Teachers, adults, and others should look into the medical history of the child before reporting child abuse.

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How to Report Child Abuse

The link below is a website that provides each hotline and center in every state to report child abuse:

• https://www.childwelfare.gov/topics/responding/reporting/

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References

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External links

• University of Chicago: Cutaneous Manifestations of Child Abuse [2]

Source of the article : Wikipedia