Which conditions are included in the differential diagnoses of physical child abuse when bruising is the presenting symptom?

Updated: Apr 24, 2017
  • Author: Angelo P Giardino, MD, MPH, PhD; Chief Editor: Caroly Pataki, MD  more...
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Answer

Bruises

For bruises, the differential diagnoses include the following:

  • Mongolian spots (collection of melanocytes producing a bluish color present at birth in 80% of black children and in many other ethnicities); see images below

  • Hemangiomas (overgrowth of capillaries)

  • Eczema

  • Phytophotodermatitis (cutaneous phototoxic cutaneous eruption)

  • Erythema multiforme (multishaped red lesions believed to be a sensitivity reaction)

  • Idiopathic thrombocytopenic purpura (ITP)

  • Bleeding disorders (eg, hemophilia)

  • Malignancy

  • Ehlers-Danlos syndrome

  • Folk-healing practices (eg, coining, cupping; see Burns, below)

    Mongolian spots on a dark-skinned child. Mongolian spots on a dark-skinned child.
    Mongolian spots on a light-skinned child. Mongolia Mongolian spots on a light-skinned child. Mongolian spots can have a greenish cast depending on the skin color of the child.

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