Case reportStaphylococcal scalded skin syndrome mimicking child abuse by burning
Introduction
Burns and scalds represent 6–20% of all child abuse cases [1] and up to 26% of paediatric burn unit admissions are due to deliberately inflicted injuries [2], [3]. Nevertheless, child abuse by burning is often under-recognized and under-reported, because of the difficulty of identifying non-accidental burns and scalds [4], and up to 50% of children undergo repeated abuse after they return home [1], [5], [6].
However, it must be emphasized that burns and scalds may be mimicked by medical conditions, such as bullous impetigo [7], [8], phytophotodermatitis [9], contact dermatitis [10], and eczema [11], and a mistaken diagnosis and report of child abuse by burning has important consequences for the family and for the child itself.
In this paper, we present two cases of suspected inflicted burns and scalds, which were later diagnosed as staphylococcal scalded skin syndrome (SSSS).
Section snippets
Case 1
A 6-month-old girl was referred to the emergency room of the City Hospital of Padova by her mother, at the request of the nursery-school teacher, who had found suspicious skin lesions on the face of the baby. Her parents were Nigerian immigrants who had been resident in Italy for 3 years. The child had not been brought to the nursery-school in the previous 10 days.
Physical examination revealed an unfebrile child in good clinical condition, with psychomotor development adequate for her age. A
Discussion
SSSS is a blistering skin disease induced by exfoliative toxins of certain strains of S. aureus. An overall incidence of about 0.1 cases per 1 million inhabitants per year has recently been calculated. The age distribution shows two clusters: one in the early age (0–12 years) and another in elderly patients (54–75 years) [12]. Clinical features may vary from a few localized blisters to generalised erythema and exfoliation. In the localized form, the toxin is produced directly in the skin by S.
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Cutaneous mimics of child abuse and neglect: Part II
2022, Journal of the American Academy of DermatologyCitation Excerpt :In a sample of 29 children with congenital bleeding disorders who initially presented with concerns for abuse, 45% had von Willebrand disease and 51.8% had hemophilia.9 Other less common bleeding disorders are included.3,7,11,13-29 In rare cases, oncologic and proliferative disorders have garnered suspicion for child abuse secondary to thrombocytopenia, increasing the propensity to bleed and bruise from minor trauma.
Images in Emergency Medicine
2008, Annals of Emergency MedicineCitation Excerpt :A typical lesion has a diameter of 0.5 to 0.8 cm and a well-defined smooth edge (Figure 3). Lesions in various stages of healing may be misdiagnosed as staphylococcal bullous impetigo or varicella virus infection.3 These cases are probably underreported because of low index of suspicion.
A Systematic Review of Pediatric Nonaccidental Burns: Protecting the Children Through Knowledge, Vigilance, and Prevention.
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