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Child Abuse and Neglect

Dennis H. Penzell, DO
JAMA. 1986;255(9):1136. doi:10.1001/jama.1986.03370090057011.
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To the Editor.—  Your recent COUNCIL REPORT on child abuse and neglect,1 as well as an earlier JAMA article,2 concerning sexual abuse in children, enumerated many physical and behavioral signs of sexual abuse. Considering the lack of physical abnormalities, except for venereal infections, there may be very few signs leading to a clear conclusion of sexual abuse.3 Frequently, the true diagnosis lies hidden, while the victim receives medical care for other complaints.4I would like to suggest a potentially important physical finding not mentioned in the COUNCIL REPORT or several other recent articles concerning sexual abuse in children.2-5The appearance of unexpected loose hair or hairs in the perianal or genital area of prepubertal children should make the examiner suspicious of sexual abuse.

Report of a Case.—  A 5-year-old male child was brought into our clinic for his annual school examination. The examination was entirely


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