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August 1, 1986, Vol 256, No. 5 >
ARTICLE | August 1, 1986

Schönlein-Henoch Purpura Misdiagnosed as Suspected Child Abuse: Title and subTitle BreakA Case Report and Literature Review FREE

Jeffrey Brown, MD, MPH; Paul Melinkovich, MD
[+] Author Affiliations

Reprints not available.


JAMA. 1986;256(5):617-618. doi:10.1001/jama.1986.03380050085026
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References

IN 1962, Kempe and his associates1 published their classic work, "The Battered Child Syndrome," in The Journal. Since then, the awareness and sensitivity of both the medical profession and lay community to the problem of child abuse have increased. Every year, more than 1 million children in the United States are seriously abused by their parents, guardians, or others, and between 2000 and 5000 children die as a result of their injuries.2,3

Cutaneous lesions are, by far, the most common presenting physical findings of child abuse.4 Several articles and reviews,4-7 including diagnostic guidelines recently published in JAMA,8 have documented the most common manifestations of lesions that result from nonaccidental trauma and injury. Unfortunately, typical or atypical presentations of skin disorders, not resulting from trauma or injury, can be misdiagnosed as suspected child abuse. We report a case as an example.

Report of a Case  An

REFERENCES

1 +
Kempe CH, Silverman FN, Steele BF, et al:  The battered child syndrome . JAMA 1961;;181:17-24.
2 +
An Approach to Preventing Child Abuse . Chicago, National Committee for Prevention of Child Abuse, 1983;.
3 +
Executive Summary: National Study of the Incidence and Severity of Child Abuse and Neglect . US Dept of Health and Human Services, 1983;.
4 +
Ellerstein NS:  The cutaneous manifestations of child abuse and neglect . AJDC 1979;;133:906-909.
5 +
Sussman SJ:  Skin manifestations of the battered child syndrome . J Pediatr 1968;;72:99-101.
6 +
Reece RM, Grodin MA:  Recognition of nonaccidental injury . Pediatr Clin North Am 1985;;32:41-60.
7 +
Pascoe JM, Hildebrandy HM, Tarrier A, et al:  Patterns of skin injury in nonaccidental and accidental injury . Pediatrics 1979;;64:245-247.
8 +
American Medical Association Report of the Council on Scientific Affairs:  AMA diagnostic and treatment guidelines concerning child abuse and neglect . JAMA 1985;;254:796-800.
9 +
Holter JC, Friedman SB:  Child abuse: Early case findings in the emergency department . Pediatrics 1968;;42:128-138.
10 +
Dungy CI:  Mongolian spots, day care centers and child abuse . Pediatrics 1982;;69:672.
11 +
Asnes RS:  Buttock bruises-mongolian spot . Pediatrics 1984;;74:321.
12 +
O'Hare AE, Eden OB:  Bleeding disorders and non-accidental injury . Arch Dis Child 1984;;59:860-864.
13 +
Waskerwitz S, Christoffel KK, Hauger S:  Hypersensitivity vasculitis presenting as suspected child abuse: Case report and literature review . Pediatrics 1981;;67:283-284.
14 +
Asner RS, Wisotsky DH:  Cupping lesions simulating child abuse . J Pediatr 1981;;99:267-268.
15 +
Yeatman GW, Dang VV:  Cao gio (coin rubbing) . JAMA 1980;;244:2748-2749.
16 +
Coffman K, Boyce WT, Hansen RC:  Phytophotodermatitis simulating child abuse . AJDC 1985;; 139:29-40.
17 +
Adler R, Kane-Nussen B:  Erythema multiforme: Confusions with child battering syndrome . Pediatrics 1983;;72:718-720.
18 +
Schmitt BD, Gray JD, Britton HL:  Car seat burns in infants: Avoiding confusions with inflicted burns . Pediatrics 1978;;62:607-609.
19 +
Owen S, Durst RD:  Ehlers-Danlos syndrome simulating child abuse . Arch Dermatol 1984;; 120:97-101.
20 +
Roberts DL, Pope FM, Nicholls AC, et al:  Ehlers-Danlos syndrome type IV mimicking nonaccidental injury in a child . Br J Dermatol 1984;;111:341-345.
21 +
Feldman KW:  Pseudoabusive burns in Asian refugees . AJDC 1984;;138:768-769.
22 +
Vicker PG:  Henoch-Schönlein purpura: Orofacial presentation . Br J Oral Maxillofac Surg 1984;; 22:301-306.
23 +
Saulsbury FT:  Henoch-Schönlein purpura . Pediatr Dermatol 1984;;1:193-201.
24 +
Schmitt BD, Kempe CH:  Abuse and neglect of children , in Behrman RE, Vaughan VC (eds): Nelson Textbook of Pediatrics . Philadelphia, WB Saunders Co, 1983;, pp 99-105.
25 +
Krugman RD:  Child abuse and neglect: The role of the primary physician in recognition, treatment, and prevention . Primary Care 1984;; 11:527-534.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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1 +
Kempe CH, Silverman FN, Steele BF, et al:  The battered child syndrome . JAMA 1961;;181:17-24.
2 +
An Approach to Preventing Child Abuse . Chicago, National Committee for Prevention of Child Abuse, 1983;.
3 +
Executive Summary: National Study of the Incidence and Severity of Child Abuse and Neglect . US Dept of Health and Human Services, 1983;.
4 +
Ellerstein NS:  The cutaneous manifestations of child abuse and neglect . AJDC 1979;;133:906-909.
5 +
Sussman SJ:  Skin manifestations of the battered child syndrome . J Pediatr 1968;;72:99-101.
6 +
Reece RM, Grodin MA:  Recognition of nonaccidental injury . Pediatr Clin North Am 1985;;32:41-60.
7 +
Pascoe JM, Hildebrandy HM, Tarrier A, et al:  Patterns of skin injury in nonaccidental and accidental injury . Pediatrics 1979;;64:245-247.
8 +
American Medical Association Report of the Council on Scientific Affairs:  AMA diagnostic and treatment guidelines concerning child abuse and neglect . JAMA 1985;;254:796-800.
9 +
Holter JC, Friedman SB:  Child abuse: Early case findings in the emergency department . Pediatrics 1968;;42:128-138.
10 +
Dungy CI:  Mongolian spots, day care centers and child abuse . Pediatrics 1982;;69:672.
11 +
Asnes RS:  Buttock bruises-mongolian spot . Pediatrics 1984;;74:321.
12 +
O'Hare AE, Eden OB:  Bleeding disorders and non-accidental injury . Arch Dis Child 1984;;59:860-864.
13 +
Waskerwitz S, Christoffel KK, Hauger S:  Hypersensitivity vasculitis presenting as suspected child abuse: Case report and literature review . Pediatrics 1981;;67:283-284.
14 +
Asner RS, Wisotsky DH:  Cupping lesions simulating child abuse . J Pediatr 1981;;99:267-268.
15 +
Yeatman GW, Dang VV:  Cao gio (coin rubbing) . JAMA 1980;;244:2748-2749.
16 +
Coffman K, Boyce WT, Hansen RC:  Phytophotodermatitis simulating child abuse . AJDC 1985;; 139:29-40.
17 +
Adler R, Kane-Nussen B:  Erythema multiforme: Confusions with child battering syndrome . Pediatrics 1983;;72:718-720.
18 +
Schmitt BD, Gray JD, Britton HL:  Car seat burns in infants: Avoiding confusions with inflicted burns . Pediatrics 1978;;62:607-609.
19 +
Owen S, Durst RD:  Ehlers-Danlos syndrome simulating child abuse . Arch Dermatol 1984;; 120:97-101.
20 +
Roberts DL, Pope FM, Nicholls AC, et al:  Ehlers-Danlos syndrome type IV mimicking nonaccidental injury in a child . Br J Dermatol 1984;;111:341-345.
21 +
Feldman KW:  Pseudoabusive burns in Asian refugees . AJDC 1984;;138:768-769.
22 +
Vicker PG:  Henoch-Schönlein purpura: Orofacial presentation . Br J Oral Maxillofac Surg 1984;; 22:301-306.
23 +
Saulsbury FT:  Henoch-Schönlein purpura . Pediatr Dermatol 1984;;1:193-201.
24 +
Schmitt BD, Kempe CH:  Abuse and neglect of children , in Behrman RE, Vaughan VC (eds): Nelson Textbook of Pediatrics . Philadelphia, WB Saunders Co, 1983;, pp 99-105.
25 +
Krugman RD:  Child abuse and neglect: The role of the primary physician in recognition, treatment, and prevention . Primary Care 1984;; 11:527-534.

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