Nasal erosion as an uncommon sign of child abuse

Culotta, Paige; Isaac, Reena; Sarpong, Kwabena; Chandy, Binoy; Cruz, Andrea T.; Donaruma‐Kwoh, Marcella

doi:10.1016/j.ijporl.2018.02.024

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…Treatment of these injuries includes use of topical antibiotics, topical emollients, and may require surgical reconstruction if severe. 3 Limitations of this series include the small number of cases and the potential difficulty in identifying factors influencing caregiver excoriation of infants. Due to many situations being multifactorial, it is difficult to determine whether caregivers were repeatedly picking at the child's skin out of neurotic behavior in caring for the child versus a result of substance-associated delusions, a psychiatric disorder, or some cognitive deficit.…”

Section: Re Sults and Discussionmentioning

confidence: 98%

“…8 In addition to the presentations in this series, previous reports of child abuse have described nasal destruction due to scraping of the nasal secretions with a Bobby pin, and repetitive and aggressive cleaning and wiping of the nose by a caregiver. 3,4 Nasal septal destruction due to forced pacifier insertion for prolonged periods of time has also been described. 11 Findings such as these, which may suggest a traumatic cause, and persistent lesions should prompt concern for child maltreatment.…”

Section: Re Sults and Discussionmentioning

confidence: 99%

“…2 Skin erosions and excoriations are much less commonly recognized, but have been described in the literature as the result of repetitive and forceful use of household items to injure children's skin. 3,4 Neurotic excoriation, which is represented in this series, is a previously undocumented form of child physical abuse. Medical providers from multiple specialties including primary care providers, dermatologists, otorhinolaryngologists (ENT), and emergency providers may be the first to recognize these injuries in young children.…”

mentioning

confidence: 99%

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Parental neurotic excoriation injury of children: A case series of hidden physical abuse

Hines

Lang

Johnson

et al. 2021

Pediatric Dermatology

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Cutaneous injury is a commonly diagnosed manifestation of child physical abuse. 1 Well-recognized findings include bruises, abrasions, bite marks, burns, and oral injuries. 2 Skin erosions and excoriations are much less commonly recognized, but have been described in the literature as the result of repetitive and forceful use of household items to injure children's skin. 3,4 Neurotic excoriation, which is represented in this series, is a previously undocumented form of child physical abuse. Medical providers from multiple specialties including primary care providers, dermatologists, otorhinolaryngologists (ENT), and emergency providers may be the first to recognize these injuries in young children. Given that important details may be omitted from the patient history in these cases, a high index of suspicion is necessary.Neurotic excoriation, also referred to as psychogenic excoriation, self-induced skin picking, or dermatillomania, can be provoked by

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Section: Re Sults and Discussionmentioning

confidence: 98%

Section: Re Sults and Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Parental neurotic excoriation injury of children: A case series of hidden physical abuse

Hines

Lang

Johnson

et al. 2021

Pediatric Dermatology

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“…Dentro de las teorías que tratan de explicar la motivación de estas personas, están el deseo de llamar la atención, ganar gratificación emocional y reconocimiento al asumir el rol de madre dedicada, (mientras www.medigraphic.org.mx que, en privado, el niño(a) es sujeto de abuso físico y emocional), el cual es al recibir la atención del médico. 11 También se habla de un vínculo patológico madre-niño, asumiendo el rol de enfermo a través de su supuesto niño enfermo como una forma de pedir ayuda para sus propios problemas. 12 En muchas de estas madres hay una historia de traumas y abusos en su infancia, por lo que se ha sugerido que estas personas canalizan sus inseguridades y síntomas afectivos a través de conductas abusivas hacia sus hijos.…”

Section: Discussionunclassified

Hipoglucemia grave recurrente secundaria a trastorno facticio por poderes

Osorio-Acuña¹,

Angulo-Mosquera²,

Salazar-Solarte³

et al. 2021

Revista Mexicana De Pediatría

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RESUMENObjetivo: Describir un paciente pediátrico con trastorno facticio por poderes o síndrome de Münchausen. Descripción del caso: Paciente femenino de dos años con antecedente de una hermana que falleció, pero que también tuvo cuadros de hipoglucemia. Antes del ingreso más reciente, ya había registro de hospitalizaciones previas por hipoglucemia. En esta última ocasión acudió con astenia y un síncope, documentándose glucemia de 22 mg/dL. Se realizaron estudios para determinar causa de hipoglucemia, pero todos fueron normales. Mediante intervención por Psiquiatría, la madre confesó administrar insulina a la paciente de manera exógena. Conclusión: El trastorno facticio por poderes es una forma grave de maltrato infantil, en donde el cuidador realiza acciones para generar morbilidad. Su identificación temprana evitará su perpetuación y un posible desenlace fatal.

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“…47 Cartilaginous tissues of the developing nose can also be repetitively damaged by abusive caregivers, resulting in nasal erosion and deformity. 48…”

Section: Fr Ac Ture S Of the Facial Bone Smentioning

confidence: 99%

Orofacial manifestations of child maltreatment: A review

Spiller

2023

Dental Traumatology

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The recognition and reporting of child abuse and neglect continues to be a challenge in the healthcare setting. All healthcare providers, including dentists, should be aware of the high prevalence of orofacial injuries and conditions that are concerning for abuse and neglect. Sentinel injuries may appear trivial and do not require medical attention, but are unlikely caused by accidental mechanisms and, if not properly identified, often precede more severe abusive injuries. Concerning orofacial findings can manifest as bruising, eye injuries, intraoral injuries, pharyngeal perforations, facial bone fractures, and sexually transmitted infections. Abusive caregivers are likely to give inadequate explanations or no history at all to explain concerning findings. Medical providers' failure to make mandated reports about their concerns to the appropriate agencies can have significant long‐term impacts on the physical and psychological well‐being of children.

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Nasal erosion as an uncommon sign of child abuse

Cited by 4 publications

References 10 publications

Parental neurotic excoriation injury of children: A case series of hidden physical abuse

Parental neurotic excoriation injury of children: A case series of hidden physical abuse

Hipoglucemia grave recurrente secundaria a trastorno facticio por poderes

Orofacial manifestations of child maltreatment: A review

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