Bruise of child abuse - Suspected Child Abuse
Physical abuse is the most frequently reported form of child abuse, with skin being the most commonly injured organ system. Abrasions and bruises are the most common signs of child abuse on the skin. Scratches and bites are less common. Burns, hematomas, edema, and marks from physical implements are also less common but should not be missed. Physical abuse can occur in children of any age and has a mean age of 6. Mechanisms of bruising include hitting, whipping, biting, and kicking.
It is important to note that cultural practices such as cupping and coining lead to ecchymosis formation in distinctive patterns. Proper evaluation is necessary because the use of cultural practices does not exclude the potential for child abuse. In these cases, significant attention should also be focused on educating the parents to explain the adverse outcomes, discourage future harmful behavior, and suggest alternative forms of treatment.
Childhood physical abuse is a problem of epidemic proportions affecting children of all ages and economic and cultural backgrounds. It is estimated that each year over 3 million children are victims of abuse, with close to 2,000 fatalities secondary to maltreatment. Although awareness is increasing, it is often challenging to differentiate findings attributable to child abuse from those of other benign skin conditions.
T76.12XA – Child physical abuse, suspected, initial encounter
371779005 – Physical child abuse
- Congenital dermal melanocytosis (formerly Mongolian spot)
- Capillary hemangioma (see infantile hemangioma)
- Ink, dye, or paint stains
- Blue nevi, especially facial
- Coagulation disorders (factor VIII and IX deficiencies, von Willebrand's disease, idiopathic thrombocytopenic purpura [ITP], leukemia, and ASA toxicity)
- Hypersensitivity vasculitis (immunoglobulin A vasculitis [formerly Henoch-Schönlein purpura])
- Hypersensitivity reactions (erythema multiforme, erythema marginatum, erythema nodosum)
- Purpura fulminans of meningococcemia
- Incontinentia pigmenti (rare)
- Disseminated intravascular coagulation (DIC)
- Café au lait spots
- Osteogenesis imperfecta
- Gardner-Diamond syndrome
- Bruising caused by cultural practices, such as cupping and coining