Skin Injury: Bruises and Burns

  • Erin E. EndomEmail author
  • Angelo P. Giardino


Careful examination of the child’s skin is an essential component of the abuse evaluation. Injuries to the skin are common findings in maltreated children and may include (a) contusions (bruises), abrasions, and lacerations; (b) burns from scalding, direct contact with flame or hot objects, and electricity; (c) frostbite (O’Neill et al., J Trauma 13: 332–339, 1973); and (d) scars resulting from these injuries (Richardson, Cutaneous manifestations of abuse. In: Reece RM (ed) Child abuse: medical diagnosis and management. Lea & Febiger, Philadelphia, pp 167–184, 1994). In one study examining the injuries of 616 children suspected of having been abused, at least 80% of the 775 primary injuries involved the skin, including (a) bruises/ecchymoses/hematomas (56%), (b) erythema/marks (9%), (c) burns (8%), and (d) abrasions/scratches (7%) (Johnson and Showers, Child Abuse Negl 9, 207–215, 1985). Ellerstein (J Dis Child 133, 906–909, 1979, Dermatologic manifestations of child abuse and neglect. In: Ellerstein NS (ed), Child abuse and neglect: a medical reference. Wiley, New York, 1981) noted the importance of cutaneous findings in maltreated children, because the recognition of these easily observed injuries by the child’s relatives, neighbors, and schoolteachers may trigger contact with the healthcare provider. Healthcare providers evaluating children with suspicious skin findings need to consider physical abuse and/or neglect as a potential etiology and pursue a thorough evaluation.


Bruises Injury Burns Bites 


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Authors and Affiliations

  1. 1.Texas Children’s HospitalHoustonUSA
  2. 2.Department PediatricsUniversity of Utah HealthSalt Lake CityUSA

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