Progressive Rash on Child’s Leg and Groin: Child Abuse-Or Mimic?

A 4-year-old girl presented to her primary care physician with these lesions that had been present for several weeks. The child’s mother was increasingly concerned that the lesions were not of an innocent nature. The first lesion had started on the anterior aspect of the child’s leg; new lesions were now spreading to the other leg and toward the groin. The mother was worried that these were sexually transmitted or abuse-related.

The mother had 2 other children and neither had any rash. The only variable between this child and her siblings was that she attended daycare.

The physician was certain of the cause of the rash, but uncertain of its relationship to child abuse.

Are these lesions indicative of abuse?

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