Typical areas of accidental bruising:
Typical pattern of abusive bruising:
From prospective longitudinal study of children (<6 years):
- 6.7% of premobile children had at least one bruise (2.2% of babies who could not roll over and 9.8% in those who could)
- Most common site affected in all groups was below the knees, followed by ‘facial T’ and head in premobile and early mobile.
- The ears, neck, buttocks, genitalia and hands were rarely bruised (<1%).
- Gender, season or the level of social deprivation not associated with bruising patterns, although having a sibling increased the mean number of bruises.
- There was considerable variation in the number of bruises recorded between different children, which increased with developmental stage, and was greater than the variation between numbers of bruises in collections from the same child over time – so some kids do just bruise more than others?
Differential
Are you sure it isn’t a Mongolian blue spot? Or capillary haemangioma? Or erythema nodosum?
Cupping in Chinese culture! Dermatitis artefacta?