Case study

MONGOLIAN SPOTS CAN MIMIC BODY INJURIES: CASE REPORT

How to cite: Seba MC, Lima JRT, Carvalho FI, Miziara CSM, Miziara ID. Mongolian spots can mimic body injuries: case report. Persp Med Legal Pericia Med. 2021; 6: e211117.

https://dx.doi.org/10.47005/211117

Submitted 02/21/2021
Accepted 03/24/2021

The authors inform there is no conflict of interest.

MANCHAS MONGÓLICAS PODEM MIMETIZAR LESÕES CORPORAIS: RELATO DE CASO

Maria Clara Cardoso Seba (1)

http://lattes.cnpq.br/4915048056589460https://orcid.org/0000-0002-4433-9845

Julia Ribeiro Targa de Lima (1)

http://lattes.cnpq.br/8217624703392824https://orcid.org/0000-0003-2458-6512

Fabiana Iglesias de Carvalho (2)

http://lattes.cnpq.br/1196600337961291https://orcid.org/0000-0003-2381-6937

Carmen Sílvia Molleis Galego Miziara (2)

http://lattes.cnpq.br/6916238042273197 – https://orcid.org/0000-0002-4266-0117

Ivan Dieb Miziara (3)

http://lattes.cnpq.br/3120760745952876https://orcid.org/0000-0001-7180-8873

(1) Acadêmica da Faculdade de Medicina do Centro Universitário ABC, Santo André – SP, Brasil.

(2) Professora Auxiliar da disciplina de Medicina Legal, Ética Médica, Deontologia Médica e Perícias Médicas do Departamento de Saúde da Coletividade da Faculdade de Medicina do Centro Universitário ABC, Santo André – SP, Brasil.

(3) Professor Titular do Departamento de Medicina Legal, Ética Médica, Deontologia Médica e Perícias Médicas da Faculdade de Medicina do Centro Universitário ABC, Santo André, SP, Brasil.

E-mail para correspondência: mariaclaracseba@hotmail.com

ABSTRACT

Mongolian spots are congenital dermatological conditions often observed in the neonatal period resulting from the migration of melanocytes to the dermis during embryogenesis. They are bluish grey spots typically located in the lumbosacral region, which tend to regress in the first years of life. As skin lesions are frequent signs in infant maltreatment, Mongolian spots can be misinterpreted as ecchymoses, which would lead to a false diagnosis. This can culminate in serious and dramatic consequences for the patient and family, as well as overloading the public system. Therefore, it is essential that health professionals know how to differentiate Mongolian stains from injuries resulting from child abuse. This study aims to describe a case that was mistakenly attributed to mistreatment for the presence of Mongolian spots in atypical places.

Keywords: Mongolian spot, diagnosis, differential, child abuse.


Bibliographical references

  1. Patel B, Butterfield R. Common skin and bleeding disorders that can potentially masquerade as child abuse. Am J Med Genet Part C Semin Med Genet. 2015;169(4):328–36. https://doi.org/10.1002/ajmg.c.31462
  2. Gondim RMF, Muñoz DR, Petri V. Child abuse: Skin markers and differential diagnosis. An Bras Dermatol. 2011;86(3):527–36. http://dx.doi.org/10.1590/S0365-05962011000300015 
  3. Aljasser M, Al-Khenaizan S. Cutaneous mimickers of child abuse: A primer for pediatricians. Eur J Pediatr. 2008;167(11):1221–30. https://doi.org/10.1007/s00431-008-0792-0
  4. Kettner M, Birngruber CG, Niess C, Baz-Bartels M, Bunzel L, Verhoff MA, et al. Mongolian spots as a finding in forensic examinations of possible child abuse–implications for case work. Int J Legal Med. 2020;134(3):1141–8. https://doi.org/10.1007/s00414-019-02208-9
  5. Lobo I, Machado S, Selores M. Alterações cutâneas fisiológicas e transitórias do recém-nascido. Rev Nascer & Crescer. 2009;18:19‑24.
  6. Krüger EMM, Sinkos F, Uhry JF, Bezerra De Boni JC, Okamoto CT, Malta Purin KS, et al. Dermatoses in the early neonatal period: Their association with neonatal, obstetric and demographic variables. Rev Paul Pediatr. 2019;37(3):297–304. http://dx.doi.org/10.1590/1984-0462/;2019;37;3;00012 
  7. Piérard GE. Reconnaître sur la peau des signes de maltraitance infantile[Recognizing the signs of child abuse on the skin]. Rev Med Liege. 1997May;52(5):320-3. French. PMID: 9273632. Disponível em: https://orbi.uliege.be/handle/2268/167555