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Bite marks of child abuse - Suspected Child Abuse
Other Resources UpToDate PubMed

Bite marks of child abuse - Suspected Child Abuse

Contributors: Mary Spencer MD, Amy Swerdlin MD, Carol Berkowitz MD, Antoinette L. Laskey MD, MPH, MBA, FAAP
Other Resources UpToDate PubMed

Synopsis

Bite marks can be a form of abusive injury and are of particular concern because of their potential for infection. Various instruments have been used in child abuse and traditionally leave patterned imprints of their shape on the child's skin. Bite marks should be suspected when ecchymoses, abrasions, or lacerations are found in an elliptical, ovoid, or semicircular pattern.

Common locations for bite marks are on "fleshy" body parts (thighs, buttocks, cheeks), but they can occur anywhere on the body. They have been reported as a form of sexual as well as physical abuse. Bite marks have been documented on both pediatric male and female genitalia but are more commonly found in males.

A human bite typically causes less tissue destruction than that from an animal but has greater potential for infection. Aerobic and anaerobic bacteria commonly colonize the mouth such as Staphylococcus, Streptococcus, and Clostridium. Bite infections are typically polymicrobial.

Childhood physical and sexual abuse is a problem of epidemic proportions affecting children of all ages and economic and cultural backgrounds. Approximately 3.9 million cases of child abuse were investigated in 2020, with victims of substantiated cases numbering approximately 618 000. Although awareness is increasing, it is often challenging to differentiate findings attributable to child abuse from those of other benign skin conditions.

Codes

ICD10CM:
T76.12XA – Child physical abuse, suspected, initial encounter
Y04.1XXA – Assault by human bite, initial encounter

SNOMEDCT:
262555007 – Human bite - wound
371779005 – Physical child abuse

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Animal bite
  • Child bite
  • Purpura annularis telangiectodes (see Capillaritis)
  • Tinea corporis
  • Granuloma annulare

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:12/12/2022
Last Updated:12/13/2022
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Bite marks of child abuse - Suspected Child Abuse
A medical illustration showing key findings of Bite marks of child abuse : Erythema
Clinical image of Bite marks of child abuse - imageId=1587612. Click to open in gallery.  caption: 'Tiny hemorrhagic crusts and postinflammatory hyperpigmented macules in geometric arrays on the leg.'
Tiny hemorrhagic crusts and postinflammatory hyperpigmented macules in geometric arrays on the leg.
Copyright © 2024 VisualDx®. All rights reserved.