Dermatological cases are always fascinating. The clues are visual and easier to examine than many other non-specific case presentations. The research to find the most likely causes for dermatological cases challenges health care providers to critically analyze the case, possible underlying co-disorders, and the best treatment options. Case outcomes leading to resolution and return to normal integumentary functions are often rewarding for the child/adolescent and caregiver. However, some dermatologic outcomes can be overwhelming for the child/adolescent and caregiver. The Dermcase article, “Hyperpigmentation Rolled Scars,” written by Sarah York, RN and Dr. Bernard A. Cohen, is one that can be categorized as overwhelming. Why? Because the outcome of the case was diagnosed as child abuse.
Why contact us?
Child health care is all about primary prevention, so the title of this commentary poses an important question to health care providers: Have you reached out to your parents and teens during this pandemic?
In the past 22 months, as everyone is deeply entrenched in the COVID-19 crisis and life is anything but ordinary, have you, the provider, contacted parents via emails or social media platforms? Have you encouraged the parents of your pediatric and adolescent patients who have not received regular care to schedule a consultation visit?
So many parents have not made routine office visits for the children or adolescents. Many children/adolescents are lagging behind on vaccinations, routine health care screenings and physical exams and need to re-contact their pediatric practice providers. It is critical to recognize the impact of COVID-19 on children/adolescents’ emotions and the resulting fear and stress placed on families. Many children have lost their parents, grandparents and other close relatives and friends of the family during the pandemic. Stress and anxiety of parents and children/young people increase the risk of child abuse. Primary prevention, including detailed history taking and recognition of anxiety or stress, as well as other behavioral problems in combination with treatment planning, can prevent escalation to child abuse. Pediatric caregivers who make telecare and/or in-person visits play a critical role in the early recognition and prevention of child abuse.
What’s Your Child Abuse IQ? Can you answer these questions as covered in the article?
Given a possible diagnosis of child abuse, what is the relationship between skin manifestations and the history of the parents or caregiver? In addition to stress and anxiety, what factors are identified in the article as an increased risk of child abuse? Look at the picture of the right side of the child’s back, what is your differential diagnosis? [Answer the question before reading the article]What does the law require a healthcare provider to do if the diagnosis is a suspicion of child abuse?
The answers to each of the above questions can be found in the article. Glad you answered them all correctly!
Finally
Let’s proactively encourage parents to make primary care appointments for their children and adolescents. Take the time to do a detailed history and physical exam. Be alert for signs of child abuse.
And as a final note, yesterday’s 800,000 reported deaths in the United States were due to COVID-19. We mourn the loss of life and ongoing disease and the potential for more lives lost to what is now a… vaccine to prevent diseaseAlong with immunizations for all eligible individuals, COVID-19 is also monitored by adherence to evidence-based public health measures. It is time for every health care provider to tirelessly advocate for vaccinations and continued public health measures. I fear that if we are not strong proponents, the numbers
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