Child abuse

SIGNS / SYMPTOMS

Family history of easy bleeding following dental extractions or postoperatively. Other presentations include prolonged epistaxis, bleeding from circumcision, or bleeding from umbilical cord stump.

Use of medications which affect platelet function or coagulation.

History of recent viral illness.

SIGNS / SYMPTOMS

Type I (mild) and type IV (moderate-to-severe) OI: recurrent fractures in infancy and childhood; associated with dentinogenesis imperfecta (discoloured teeth) and joint laxity. Type 1 frequently has associated blue sclera.

Type II (lethal) and type III (severe, progressively deforming) OI: easily diagnosed clinically and radiologically due to the severity.

Other subtypes are exceedingly rare.

There may be a family history of the disease or of recurrent fractures, deafness, or hernias.

SIGNS / SYMPTOMS

A metabolic disorder that may be asymptomatic for some time after birth. Symptoms develop during an intercurrent illness and are those of lethargy and neurological impairment.

Co-existent subdural haemorrhages have been reported.

SIGNS / SYMPTOMS

History of prematurity and of prolonged total parenteral nutrition (TPN) and/or diuretics.

May be other co-existent disease or prolonged nutritional deprivations precipitating rickets.

SIGNS / SYMPTOMS

Appears after skin has been in contact with a psoralen (e.g., from plants such as rue, citrus fruit juices, perfumes, bergamot oil) and then exposed to sunlight.

The key is a precise history, as the lesions appear "spontaneously" and may be mistaken for scalds or bruising.

SIGNS / SYMPTOMS

Lesions are crusting and new lesions keep cropping. In particular, new lesions appear following contact with another area of affected skin (e.g., lesion on the arm touching the trunk).

Lesions may have an appearance similar to cigarette burns.

SIGNS / SYMPTOMS

Also known as congenital dermal melanocysotis.

Can occur anywhere on body, most commonly on the buttocks. Frequently found in children of Asian or southern Mediterranean origin.

Diagnosis relies on genetic susceptibility of child, presence since birth, absence of tenderness or induration, and no change in colour over succeeding days.

SIGNS / SYMPTOMS

A traditional remedy used in Southeast Asia, so a history of using traditional remedies is key to the diagnosis.

Linear marks, usually found on the back or chest and appearing over the part of the body giving rise to symptoms (e.g., appearing over chest if the child has a cough). They may also be noted in a collapsed child following resuscitative efforts.

SIGNS / SYMPTOMS

A traditional remedy, so a history of using such remedies is key to the diagnosis.

Characteristic multiple, circular, erythematous or superficial burns found around the umbilicus or chest following burning the moxa herb on the skin (although variations may be performed).

Marks are found over the part of the body giving rise to symptoms (e.g., the abdomen if the child has abdominal pain/vomiting).

SIGNS / SYMPTOMS

May present with widespread central nervous system, gastrointestinal, or skin bleeding.

History of no vitamin K prophylaxis after birth (particularly in breastfeeding mothers) aids the diagnosis.