Medical Child Abuse

Applegate, Kimberly E keapple at EMORY.EDU
Mon Nov 14 18:50:27 UTC 2016


And of course, there may also be a misdiagnosis of child abuse for HSP (Henoch Schonlein Purpura) when it presents as buttock and trunk bruising.
Kimberly

-----Original Message-----
From: Art Papier [mailto:apapier at VISUALDX.COM]
Sent: Sunday, November 13, 2016 9:55 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Medical Child Abuse

Mark,
In addition, and related, there are predictable medical diagnoses in children that have been erroneously diagnosed as child abuse.  In dermatology, lichen sclerosis which often presents with ecchymoses
(bruising) of the labia, or glans is prematurely closed as abuse.  Parents have lost their children to social services only 6 months later to be told "we made a mistake".....

https://www.ncbi.nlm.nih.gov/pubmed/25725976
Arch Pediatr. 2015 Apr;22(4):383-6. doi: 10.1016/j.arcped.2014.12.016. Epub
2015 Feb 26.
[Vulvar lichen sclerosus in children misdiagnosed as sexual abuse].

https://www.ncbi.nlm.nih.gov/pubmed/17666933
Pediatr Emerg Care. 2007 Jul;23(7):482-5.
Lichen sclerosus in the differential diagnosis of suspected child abuse cases.
Isaac R1, Lyn M, Triggs N.

Bleeding disorders, osteogenesis imperfecta, rickets, Ehlers-Danlos are a
few more examples, but there is a much longer list.   These skin signs of a
bruise, a burn like blister, a broken bone often have very quick momentum
erroneously to being abuse.   Dermatologists collect images of these
diagnoses and the photos are revelatory in helping to understand how this happens.  These are horrible incidents of diagnostic error when they occur.


Art

Art Papier MD
Associate Professor of Dermatology and Medial Informatics University of Rochester CEO VisualDx






-----Original Message-----
From: graber.mark at GMAIL.COM [mailto:graber.mark at GMAIL.COM]
Sent: Saturday, November 12, 2016 11:59 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] Medical Child Abuse

This is hopefully not a diagnosis you'll encounter, but the relatively new diagnosis of "medical child abuse" is taking hold in certain areas of the country.  Parents so charged can lose custody of their children and be subject to criminal proceedings.

The enclosed review by Maxine Eichner studies this issue from a diagnostic error perspective, and concludes that this diagnosis has no firm criteria, and may often be incorrect.  Her scholarly article will hopefully shed some light into this dark and messy area. The review was just published online by the UC Davis Law Review {50 UC Davis L. Rev. 205 (2016)}

Mark

Mark L Graber, MD FACP
President SIDM







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