Therapeutics in Dermatology
A reference textbook in dermatology
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Cutaneous signs of child abuse

16 October 2013, by LASEK-DURIEZ A.


Child abuse is a major public health problem and it is the moral, ethical, and legal responsibility of every doctor to detect cases and to intervene to prevent recurrence. Abuse brings together various behaviours that, through their repetition or their level of violence, can have physical and/or psychological consequences and an impact on personal and social development. There are three different types of abuse: physical abuse, psychological abuse, and sexual abuse. A diagnosis of child abuse must always be made with extreme care as there is a great deal at stake, and it is sometimes difficult to distinguish genuine abuse from an accident or a dermatological pathology.

Dermatologists and child safeguarding are not readily associated in the mind of doctors, yet physical abuse of a child is most commonly revealed due to dermatological manifestations. This means that dermatologists have an important role to play in the diagnosis of physical abuse; they must also be able to make a considerate distinction between a dermatological pathology that mimics abuse and genuine physical abuse. Diagnostic errors fall into two categories: false positives in children who have accidental injuries or a disease that is wrongly identified as a sign of abuse; and false negatives concerning abused children going unreported. There can be significant harm as a result of both kinds of diagnostic errors, with over 50% of those who suffer from repeated abuse returning home to a risk of subsequent serious injury or even death [1].

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