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Potentially life-threatening emergency
Physical child abuse - Skin in Infant/Neonate
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Potentially life-threatening emergency

Physical child abuse - Skin in Infant/Neonate

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Contributors: Craig N. Burkhart MD, Dean Morrell MD, Lowell A. Goldsmith MD, MPH, Nancy Esterly MD
Other Resources UpToDate PubMed

Synopsis

Physical abuse means injury to the child caused either purposely or by neglect. Physical abuse can occur in children of any age and has a mean age of 6. Neonates and infants are at highest risk for serious injury or death; death is less common after 1 year of age. It can occur by hitting, whipping, biting, kicking, choking, shaking, burning, or any physical mean. Risk factors of abuse include children of teenage parents, children with developmental disorders or illness, substance abuse in the home, violence between siblings, unwanted pregnancy, and poverty. See also child sexual abuse.

Codes

ICD10CM:
T76.12XA – Child physical abuse, suspected, initial encounter

SNOMEDCT:
371779005 – Physical child abuse

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Bruising: The cause of bruising may be due to a medical disorder and not abuse. Consider hemophilia, idiopathic thrombocytopenic purpura (ITP), disseminated intravascular coagulation (DIC), and platelet disorders due to drugs or inherited disorders such as Ehlers-Danlos syndrome.

Burns: Burns can be confused with impetigo when the impetigo presents with scattered erosions and thick crusts. Laxative-induced diarrhea and subsequent occlusion by a diaper can lead to severe irritant dermatitis mimicking a scald-like immersion burn.

Fractures: When fractures are evident, consider osteogenesis imperfecta.

Other: Bizarre, streaky hyperpigmentation with or without vesicles may be seen with phytophotodermatitis. Increased uric acid with Lesch-Nyhan syndrome is associated with self-mutilation.

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 03/29/2017
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Potentially life-threatening emergency
Physical child abuse - Skin in Infant/Neonate
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Physical child abuse : Excoriation, Geometric configuration, Laceration, Linear configuration, Skin erosion, Ecchymosis
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