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Abstract：
BACKGROUND: Recognizable skin findings of child physical abuse include bruises, abrasions, lacerations, bite marks, burns, and oral injuries. Self-induced skin picking, or neurotic excoriation, can correspond to emotional stress, underlying psychiatric illness, or substance abuse. Parental neurotic excoriation injury of children has not been reported previously as a form of physical abuse.
METHODS: We present a case series of five children abused via parental excoriation. All affected children were three years of age or younger and otherwise healthy. Each child presented with wounds determined to be consistent with chronic picking. Patient age, injury location, and in some cases, witness accounts confirmed the lesions were not self-inflicted.
RESULTS: In three cases, caregivers reported methamphetamine use. In these cases, caregivers repeatedly picked or wiped the infants\' skin. In two cases, the caregiver demonstrated personal neurotic excoriation behavior, which was imposed upon her children resulting in similar lesions. One affected child died at 14 days of age from abusive head trauma, while the other four children were placed in foster care by Child Protective Services.
CONCLUSIONS: Excoriation injury places children at risk for significant scarring and other long-term effects. We report examples demonstrating that repetitive skin injury by caregivers is a diagnostic consideration for abuse in young children.
METHODS: We present a case series of five children abused via parental excoriation. All affected children were three years of age or younger and otherwise healthy. Each child presented with wounds determined to be consistent with chronic picking. Patient age, injury location, and in some cases, witness accounts confirmed the lesions were not self-inflicted.
RESULTS: In three cases, caregivers reported methamphetamine use. In these cases, caregivers repeatedly picked or wiped the infants\' skin. In two cases, the caregiver demonstrated personal neurotic excoriation behavior, which was imposed upon her children resulting in similar lesions. One affected child died at 14 days of age from abusive head trauma, while the other four children were placed in foster care by Child Protective Services.
CONCLUSIONS: Excoriation injury places children at risk for significant scarring and other long-term effects. We report examples demonstrating that repetitive skin injury by caregivers is a diagnostic consideration for abuse in young children.
摘要：
背景：儿童身体虐待的可识别皮肤发现包括瘀伤，擦伤,撕裂,咬痕,烧伤,和口腔损伤。自我诱导的皮肤采摘，或者神经质的痛击，可以对应于情绪压力，潜在的精神疾病，或药物滥用。先前尚未报道过父母对儿童的神经性剥脱伤作为身体虐待的一种形式。
方法：我们介绍了一个案例系列，其中有5名儿童因父母遭受虐待。所有受影响的儿童均为3岁或更小，其他方面健康。每个孩子都有伤口，确定与长期采摘一致。患者年龄,损伤位置,在某些情况下,目击者的陈述证实这些病变不是自己造成的。
结果：在三种情况下，护理人员报告使用甲基苯丙胺。在这些情况下,护理人员反复采摘或擦拭婴儿的皮肤。在两种情况下，看护者表现出个人的神经质痛斥行为，这是对她的孩子造成的类似病变。一名受影响的儿童在14天大的时候死于虐待性头部创伤，而其他四个孩子则由儿童保护服务机构寄养。
结论：擦伤使儿童面临严重疤痕和其他长期影响的风险。我们报告的例子表明，护理人员的重复性皮肤损伤是幼儿虐待的诊断考虑因素。
方法：我们介绍了一个案例系列，其中有5名儿童因父母遭受虐待。所有受影响的儿童均为3岁或更小，其他方面健康。每个孩子都有伤口，确定与长期采摘一致。患者年龄,损伤位置,在某些情况下,目击者的陈述证实这些病变不是自己造成的。
结果：在三种情况下，护理人员报告使用甲基苯丙胺。在这些情况下,护理人员反复采摘或擦拭婴儿的皮肤。在两种情况下，看护者表现出个人的神经质痛斥行为，这是对她的孩子造成的类似病变。一名受影响的儿童在14天大的时候死于虐待性头部创伤，而其他四个孩子则由儿童保护服务机构寄养。
结论：擦伤使儿童面临严重疤痕和其他长期影响的风险。我们报告的例子表明，护理人员的重复性皮肤损伤是幼儿虐待的诊断考虑因素。
