Cutaneous Manifestations of Child Abuse

Incidence of Abusive Cutaneous Injuries Cutaneous injuries include bruises, petechiae, burns, bite marks, lacerations, and abrasions. In 2004 data from the National Child Abuse and Neglect Data System of the US Department of Health and Human Services indicated that physical abuse constituted 17.5% of the total substantiated reports for child maltreatment.' Data from the first Canadian incidence study of child maltreatment showed that 49% of 7,672 child protection investigations in 1998 were substantiated. More than 13% of these involved moderate injuries, defined as cases in which physical harm was observed. Two thirds of these injuries were due to bruises, cuts, or scrapes2 In other studies, 50% to 60% of all physical abuse cases had skin injuries, either in isolation or in combination with other abusive injuries3v4 Cutaneous injuries are the single most common presentation of physical child abuse. Skin: An Overview Human skin is an extraordinary organ, accounting for 16% of the weight of the human body.5 It serves many important functions, including control of thermoregulation, regulation of blood pressure, protection from microorganisms and toxins, and maintenance of hydration. Normal skin is supple, allowing facial expressions and joint mobility. The skin interfaces with the environment, providing many of our sensory experiences as well as the unique visage with which we interact with our en~ironment.~