Is Physical Abuse or Blue Sclera? A Case Report

Authors

  • Bedir Korkmaz Adnan Menderes Üniversitesi Adli Tıp Anabilim Dalı
  • Mustafa Selim Özkök
  • Füsun Çallak Kallem
  • Musa Dirlik
  • Ufuk Katkıcı

DOI:

https://doi.org/10.17986/blm.2017127143

Keywords:

child physical abuse, blue sclera, mimickers of physical abuse, forensic medicine

Abstract

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.

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Author Biography

  • Bedir Korkmaz, Adnan Menderes Üniversitesi Adli Tıp Anabilim Dalı
    Adnan Menderes Üniversitesi Adli Tıp Anabilim Dalı Araştırma Görevlisi

References

Pinheiro PS. World report on violence against children. New York:United Nations Secretary-General’s study on violence against children, 2006.

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. https://doi.org/10.1097/01.pec.0000081234.20228.33 DOI: https://doi.org/10.1097/01.pec.0000081234.20228.33

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. DOI: https://doi.org/10.1001/archpedi.1993.02160250089028

Jenny C, Hymel KP, Ritzen A, Reinert SE, Hay TC. Analysis of missed cases of abusive head trauma. JAMA 1999;281(7):621-26 https://doi.org/10.1001/jama.281.7.621 DOI: https://doi.org/10.1001/jama.281.7.621

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. https://doi.org/10.1097/PEC.0b013e31818e9f5d DOI: https://doi.org/10.1097/PEC.0b013e31818e9f5d

Hindley N, Ramchandani PG, Jones DP. Risk factors for recurrence of maltreatment: a systematic review. Arch Dis Child 2006;91(9):744-52. https://doi.org/10.1136/adc.2005.085639 DOI: https://doi.org/10.1136/adc.2005.085639

Lee SJ, BellamyJL, Guterman NB. Fathers, physical child abuse and neglect. Child Maltreatment 2009;14(3):227-31. https://doi.org/10.1177/1077559509339388 DOI: https://doi.org/10.1177/1077559509339388

Taner Y, Gökler B. Çocuk istismarı ve ihmali: psikiyatrik yönleri. Hacettepe Tıp Dergisi 2004;35:82-86.

Amy Swerdlin, Carol Berkowitz, Noah Craft. Cutaneous signs of child abuse. J Am Acad Dermatol 2007;57(3):371-92. https://doi.org/10.1016/j.jaad.2007.06.001 DOI: https://doi.org/10.1016/j.jaad.2007.06.001

Oranje A, Bilo RA. Skin signs in child abuse and differential diagnosis. Minerva Pediatr 2011;63(4):319-25.

Wardinsky TD. Genetic and congenital defect conditions that mimic child abuse. J Fam Pract 1995;41(4):377-83.

Puttgen KB, Lin DD. Neurocutaneous vascular syndromes. Childs Nerv Syst 2010;26(10):1407 -15 https://doi.org/10.1007/s00381-010-1201-3 DOI: https://doi.org/10.1007/s00381-010-1201-3

Arı Ş, Haspolat K, Çaça İ. Metabolik kemik hastalıkları ve göz. Turkiye Klinikleri J Ophthalmol 2008;17(4):276-81.

Tunç B. Çocuklarda demir eksikliği anemisi. Türkiye Çocuk Hast Der 2008;2(2):43-47.

Tarım Ö. Göz ve endokrinoloji. Güncel Pediatri 2007;5:18-22.

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Published

2017-04-29

Issue

Section

Case Report

How to Cite

1.
Korkmaz B, Özkök MS, Kallem F Çallak, Dirlik M, Katkıcı U. Is Physical Abuse or Blue Sclera? A Case Report. Bull Leg Med. 2017;22(1):64-66. https://doi.org/10.17986/blm.2017127143