Dermatological emergencies: Skin manifestations of abuse

Abstract

Abuse takes many forms, including physical abuse, sexual abuse, emotional abuse, and neglect. The definition of child abuse, by the Center for Prevention and Treatment of Child Abuse (USA), is stated as the mental and physical injury, sexual abuse, neglect, or mistreatment of individuals under 18 years of age, perpetrated by a caregiver, which indicates that the health of the child is threatened [1]. Physicians must always be alert for signs indicating any manifestation of abuse, looking for symptoms beyond skin lesions. The authors consider any form of abuse a medical emergency, recognizing that most children, or elderly, are unable to articulate their condition or alert authorities of any wrongdoing and rely nearly exclusively on the awareness of astute professionals. Many cases of abuse are left unrecognized by professionals, the findings being exceedingly subtle, often written off as innocuous lesions. Early recognition is crucial, not only to prevent subsequent injury which occurs in 30-70 % of children, but reports have indicated that abuse tends to increase in severity with time [2], and early intervention may avert these avoidable events.