ABSTRACT
This is a 9-year-old girl who was brought from school after school staff made a Child Protective Services report about possible burns on the child’s buttocks. The lesions as shown in the image were noted when the child was changing for gym class (Image 117).
Are the school staff’s concerns reasonable given the image provided?
What additional information would be helpful to determine the aetiology?
https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429170423/e1d751c1-a9c7-4bb9-9d59-53742c84031a/content/fig117.jpg"/>268The lesions are consistent with healing staph impetigo. While this could be confused with cigarette burns based on their size, the location and appearance suggest an infection or other cause. 1
The child denied that these are cigarette burns. Her mother gave a history that the child had been wearing a pair of jeans with large metal studs above the back pockets. The child had a history of a metal allergy in the past. The areas under the studs became very irritated and the child scratched them. She developed impetiginous lesions with large bullous lesions that healed in this circular fashion.
