{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T02:12:29Z","timestamp":1772503949968,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The phenomenon of child abuse\/maltreatment is underestimated and often represents a difficult challenge for healthcare professionals and forensic pathologists who must proceed with the differential diagnosis with accidental or self-induced events, or with lesions due to pathologies that overlap with that of mistreatment, defined as \u201cMimics\u201d. This study presents a case series with the aim of discussing lesions that may mimic signs of physical abuse in children but are due to a different etiology to raise awareness and train healthcare professionals and forensic pathologists on possible confounding factors in order to avoid diagnostic errors. Six cases of \u201cMimics\u201d out of 418 cases of suspected mistreatment (1.43% of cases) were identified, presenting skin lesions initially classified as injuries of abuse due to their location and type and, in particular, sexual abuse for three cases. Then, the lesions and the subjects, in particular the anamnestic history, were examined by a multidisciplinary team and the diagnosis of genital lichen sclerosus et atrophicus in three cases, and the results of popular healing techniques (i.e., \u201ccupping\u201d) in the other three cases were ascertained. These situations require specific skills and a forensic background from healthcare professionals to conduct a correct differential diagnosis and the intervention of a multidisciplinary team to investigate every possible pathology or alternative therapeutic practice that could simulate child abuse. In particular, when \u201cmimics\u201d are due to alternative medicine, it should not strictly be considered child abuse, but professionals must be aware of the hypothesis of mistreatment in case of non-medical indication or potential personal injuries from other crimes, such as illegal practice of the medicine. This awareness is also crucial to direct the child toward appropriate medical care, and it is essential to recognize that these conditions can coexist within the same clinical presentation.<\/jats:p>","DOI":"10.3390\/children11091103","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T04:15:01Z","timestamp":1725855301000},"page":"1103","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["\u201cMimics\u201d of Injuries from Child Abuse: Case Series and Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"given":"Martina","family":"Focardi","sequence":"first","affiliation":[{"name":"Forensic Medical Sciences, Department of Health Science, University of Florence, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Gori","sequence":"additional","affiliation":[{"name":"Forensic Medical Sciences, Department of Health Science, University of Florence, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Romanelli","sequence":"additional","affiliation":[{"name":"Forensic Medical Sciences, Department of Health Science, University of Florence, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1620-0553","authenticated-orcid":false,"given":"Francesco","family":"Santori","sequence":"additional","affiliation":[{"name":"Forensic Medical Sciences, Department of Health Science, University of Florence, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5407-2160","authenticated-orcid":false,"given":"Ilenia","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Laboratory of Personal Identification and Forensic Morphology, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3189-8752","authenticated-orcid":false,"given":"Regina","family":"Rensi","sequence":"additional","affiliation":[{"name":"Forensic Medical Sciences, Department of Health Science, University of Florence, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Defraia","sequence":"additional","affiliation":[{"name":"Forensic Medical Sciences, Department of Health Science, University of Florence, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossella","family":"Grifoni","sequence":"additional","affiliation":[{"name":"Forensic Medical Sciences, Department of Health Science, University of Florence, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Gualco","sequence":"additional","affiliation":[{"name":"Forensic Medical Sciences, Department of Health Science, University of Florence, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2389-2836","authenticated-orcid":false,"given":"Laura","family":"Nanni","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Unit, Department of Intensive Care and Emergency, Meyer Children\u2019s Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Losi","sequence":"additional","affiliation":[{"name":"Responsible GAIA Service, Meyer Children\u2019s Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"key":"ref_1","unstructured":"Brown, C.L., Yilanli, M., and Rabbitt, A.L. 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