Child Abuse Pocket Atlas, Volume 1. Randell Alexander, MD, PhD

      Figure 1-24-b. Splash mark on the right flank.

      In addition to physical abuse, this child was also neglected as the caregivers did not seek immediate medical attention. This child suffered additional pain, had an increased risk of infection, and had an injury that resulted in scarring.

      IMMERSION BURNS

IMMERSION BURN SCAR

       Case Study 1-25

      This 3-year-old was brought to the outpatient department due to allegations of sexual abuse. No physical evidence of sexual abuse was seen. Examination revealed completely healed immersion burns to the buttocks. The mother reported that this child burned herself in the bathtub. No burns were seen on the feet or hands. This is presumptive evidence of physical abuse as the history offered was not consistent with this burn pattern. The child was also neglected as medical care was not sought for the burn.

      Figure 1-25. Immersion-burn scar along the right buttock.

      IMMERSION BURNS

“DOUGHNUT” BURN PATTERN

       Case Study 1-26

      This preschooler reportedly burned herself in the bathtub.

      Figure 1-26-a. Note the “doughnut” distribution whereby the buttock areas against the cooler bathtub are spared, but the skin above is burned.

      Figure 1-26-b. Closer view of the buttocks burn shows symmetry not expected when the injury is unintentional.

      IMMERSION BURNS

WATER LINES SHOWN BY BURNS

       Case Study 1-27