Dermatology clinical case

  • Raquel Vilela Oliveira Department of Pediatrics, Unidade Local de Saúde do Alto Minho
  • Diana Bordalo Department of Pediatrics, Centro Hospitalar Médio Ave. Unidade de Vila Nova de Famalicão
  • Sónia Carvalho Department of Pediatrics, Centro Hospitalar Médio Ave. Unidade de Vila Nova de Famalicão
  • Paula Fonseca Adolescent Medicine Unit, Department of Pediatrics, Centro Hospitalar Médio Ave. Unidade de Vila Nova de Famalicão
Keywords: adolescence, self-inflicted injuries, early intervention, purpura

Abstract

A previously healthy 15-year-old girl was sent to the Pediatric Emergency Department by the general practitioner due to suspicion of a hematological condition. The girl presented with ecchymotic lesions on the anterior region of the thorax and antero-proximal region of the upper limbs, which had apparently worsened in the last 24 hours. She denied trauma or impact sports, fever or recent infections, and blood loss or other symptoms. Laboratory evaluation showed no alterations and urine toxicology screening was negative. When confronted with normal laboratory evaluation, the girl confessed intentional self-inflicted injuries following a discussion with her mother. Parents were made aware of the situation, and a pediatric psychiatry consultation was recommended. After discharge, follow-up in the girl’s home country was assured.
With this report, the author intend to raise awareness of the importance of maintaining a high index of suspicion to non-suicidal self-injury, identifying alarm signs and establishing early preventive strategies.

References

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Valencia-Agudo F, Burcher GC, Ezpeleta L, Kramer T. Nonsuicidal self-injury in community adolescents: A systematic review of prospective predictors, mediators and moderators. Journal of Adolescence. 2018; 65:25-38.

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Palmer C, Connor C, Channa S, Lavis A, Leung N, Parsons N, Birchwood M. The Development of First-Episode Direct Self-Injurious Behavior and Association with Difficulties in Emotional Regulation in Adolescence. Suicide and Life-Threatening Behavior. The American Association of Suicidology. 2018. DOI: 10.1111/sltb.12512.

Published
2020-03-24
How to Cite
Oliveira, R. V., Bordalo, D., Carvalho, S., & Fonseca, P. (2020). Dermatology clinical case. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 29(1), 59-61. https://doi.org/10.25753/BirthGrowthMJ.v29.i1.16074
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