Is Physical Abuse or Blue Sclera? A Case Report
Abuse of the children continues to be an important problem of public health and social welfare. Approximately 4-16% of all children are exposed physical abused and 155.000 children worldwide lost their life cause of the abuse and neglect in each year.
It is usually difficult to distinguish the skin diseases that mimics maltreatment and child abuse for clinicians. To distinguish between these two conditions a dermatologist may be consulted. Because skin damage is the most recognizable and common form of the abuse.
A seven years old girl who have been subjected to physical abuse by her father according to the hospital records and sent to our clinic for the evaluation of lesions on the face and body in terms of congenital or a sign of physical abuse has investigated in this study. Patient was consulted to pediatrics, dermatology and ophthalmology. It was found that the vision is normal, no retinal damage and blue sclera (thinning of the retina) was detected. The lesions on face and body were consistent with the port-wine stains. These findings on face and body were not associated with physical abuse. It is highlighted in this study that the lesions of skin disease and some metabolic diseases should be considered in the differential diagnosis of physical abuse.
2. Oral R, Blum KL, Johnson C. Fractures in young children: are physicians in the emergency department and orthopedic clinics adequately screening for possible abuse? Pediatr Emerg Care 2003;19(3):148-53. doi:10.1097/01.pec.0000081234.20228.33
3. Leventhal JM, Thomas SA, Rosenfield NS, Markowitz RI. Fractures in young children. Distinguishing child abuse from unintentional injuries. Am J Dis Child 1993;147(1):87-92.
4. Jenny C, Hymel KP, Ritzen A, Reinert SE, Hay TC. Analysis of missed cases of abusive head trauma. JAMA 1999;281(7):621-26 doi:10.1001/jama.281.7.621
5. Oral R, Yagmur F, Nashelsky M, Turkmen M, Kirby P. Fatal abusive head trauma cases: consequence of medical staff missing milder forms of physical abuse. Pediatr Emerg Care 2008;24(12):816-21. doi:10.1097/PEC.0b013e31818e9f5d
6. Hindley N, Ramchandani PG, Jones DP. Risk factors for recurrence of maltreatment: a systematic review. Arch Dis Child 2006;91(9):744-52. doi:10.1136/adc.2005.085639
7. Lee SJ, BellamyJL, Guterman NB. Fathers, physical child abuse and neglect. Child Maltreatment 2009;14(3):227-31. doi:10.1177/1077559509339388
8. Taner Y, Gökler B. Çocuk istismarı ve ihmali: psikiyatrik yönleri. Hacettepe Tıp Dergisi 2004;35:82-86.
9. Amy Swerdlin, Carol Berkowitz, Noah Craft. Cutaneous signs of child abuse. J Am Acad Dermatol 2007;57(3):371-92. doi:10.1016/j.jaad.2007.06.001
10. Oranje A, Bilo RA. Skin signs in child abuse and differential diagnosis. Minerva Pediatr 2011;63(4):319-25.
11. Wardinsky TD. Genetic and congenital defect conditions that mimic child abuse. J Fam Pract 1995;41(4):377-83.
12. Puttgen KB, Lin DD. Neurocutaneous vascular syndromes. Childs Nerv Syst 2010;26(10):1407 -15 doi:10.1007/s00381-010-1201-3
13. Arı Ş, Haspolat K, Çaça İ. Metabolik kemik hastalıkları ve göz. Turkiye Klinikleri J Ophthalmol 2008;17(4):276-81.
14. Tunç B. Çocuklarda demir eksikliği anemisi. Türkiye Çocuk Hast Der 2008;2(2):43-47.
15. Tarım Ö. Göz ve endokrinoloji. Güncel Pediatri 2007;5:18-22.
The Bulletin of Legal Medicine is an open access scientific journal. Open access means that all content is freely available without charge to the user or his/her institution on the principle that making research freely available to the public supports a greater global exchange of knowledge. The Journal and content of this website is licensed under the terms of the Creative Commons Attribution (CC BY) License. This is in accordance with the Budapest Open Access Initiative (BOAI) definition of open access.
The Creative Commons Attribution License (CC BY) allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed.
The Bulletin of Legal Medicine requires the author as the rights holder to sign and submit the journal's agreement form prior to acceptance. The authors retain copyright of their work and grant the Association for its publication. This ensures both that The Journal has the right to publish the article and that the author has confirmed various things including that it is their original work and that it is based on valid research.
Authors who publish with this journal agree to the following terms:
*Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
*Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
*Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.