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April 1996

Picture of the Month

Author Affiliations

From the Departments of Pediatrics (Dr Fischer) and Social Work (Mr Allasio), Children's Hospital of Michigan, and Medical Examiner's Office of Wayne County (Dr Hammel), Detroit, Mich; and the American Board of Pediatrics, Chapel Hill, NC (Dr Tunnessen).

Arch Pediatr Adolesc Med. 1996;150(4):429-430. doi:10.1001/archpedi.1996.02170290095016

A 3-MONTH-OLD infant with poor weight gain (weight at presentation only 570 g greater than birth weight) was noted to have skin lesions on both hands and feet (Figure 1 through Figure 3). No explanation for the lesions was initially offered by the mother. Later, she suggested that they may have resulted from scratches from a ring.

Denouement and Discussion 

Human Bite Marks  Unexplained injuries occurring in children should arouse suspicion of possible abuse. When a caretaker's explanation of injuries changes, the suspicion of abuse should be reinforced. Human bite marks rarely occur accidentally and are good indicators of inflicted injury.1 Bite marks found on infants may represent punishment for crying or soiling. Older children may be bitten in the context of physical assault or during sexual abuse.A human bite mark has a parabolic shape reflecting the shape of the human dental arch.1 No single tooth's impression