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August 1, 1986

Schönlein-Henoch Purpura Misdiagnosed as Suspected Child AbuseA Case Report and Literature Review

Author Affiliations

From the Department of Pediatrics. University of Colorado Health Sciences Center, Denver (Drs Brown and Melinkovich), and the Denver Department of Health and Hospitals (Dr Melinkovich).

JAMA. 1986;256(5):617-618. doi:10.1001/jama.1986.03380050085026

IN 1962, Kempe and his associates1 published their classic work, "The Battered Child Syndrome," in The Journal. Since then, the awareness and sensitivity of both the medical profession and lay community to the problem of child abuse have increased. Every year, more than 1 million children in the United States are seriously abused by their parents, guardians, or others, and between 2000 and 5000 children die as a result of their injuries.2,3

Cutaneous lesions are, by far, the most common presenting physical findings of child abuse.4 Several articles and reviews,4-7 including diagnostic guidelines recently published in JAMA,8 have documented the most common manifestations of lesions that result from nonaccidental trauma and injury. Unfortunately, typical or atypical presentations of skin disorders, not resulting from trauma or injury, can be misdiagnosed as suspected child abuse. We report a case as an example.

Report of a Case  An