Abstract
Mongolian spots (MS) are congenital dermal conditions resulting from neural crest-derived melanocytes migration to the skin during embryogenesis. MS incidences are highly variable in different populations. Morphologically, MS present as hyperpigmented maculae of varying size and form, ranging from round spots of 1 cm in diameter to extensive discolorations covering predominantly the lower back and buttocks. Due to their coloring, which is also dependent on the skin type, MS may mimic hematoma thus posing a challenge on the physician conducting examinations of children in cases of suspected child abuse. In the present study, MS incidences and distribution, as well as skin types, were documented in a collective of 253 children examined on the basis of suspected child abuse. From these data, a classification scheme was derived to document MS and to help identify cases with a need for recurrent examination for unambiguous interpretation of initial findings alongside the main decisive factors for re-examination such as general circumstances of the initial examination (e. g., experience of the examiner, lighting conditions) and given dermatological conditions of the patient (e. g., diaper rash).
Highlights
Examinations of children suspected to have suffered from child abuse have been a constantly growing field of expertise in forensic routine casework with regard to frequency and extent over the past two decades
Mongolian spots (MS) are a congenital dermatological condition believed to result from neural crest-derived melanocytes migrating to the skin during embryogenesis, which normally reside at the dermal-epidermal junction [2, 3]
Analysis of skin type classification showed a predominance of type 2 and 3 (Fig. 1a) with patients displaying MS predominantly found in types 3 and 4 (Fig. 1b)
Summary
Examinations of children suspected to have suffered from child abuse have been a constantly growing field of expertise in forensic routine casework with regard to frequency and extent over the past two decades. The prevalence of children aged 0–14 suffering from some kind of physical abuse has been estimated at 22.9 % in the European Union [1]. MS incidences vary highly between different populations ranging from 0.04 to 96.53% (Table 1). They belong to the group of congenital dermal melanocytoses comprising MS, nevus of Ito 1142 Table 1 Incidence of Mongolian spots in different ethnicities. Shih et al [10] Fehrabas et al [11] Reza et al [12] Kanada et al [13]
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