Dermatological symptoms and sexual abuse: a review and case reports.
Dermatological symptoms in cases of sexual abuse can be very diverse. To establish a causal relationship between skin diseases and sexual abuse is particularly difficult. In dermatology, three main areas of presentation can be identified. ACUTE CONSEQUENCES: Direct injuries found on the genitalia and body. Behaviour and psychological changes seen. Sexually transmitted diseases (STD) may be identified, after an appropriate incubation period. LONG-TERM CONSEQUENCES: In the long term, even decades later, patients may manifest with a wide spectrum of psychosomatic manifestations of skin diseases, particularly factitious disorders. IMITATIONS: A group whose skin manifestations may mimic and be mistaken for sexual abuse. The initial suspicion of sexual abuse and the need for specific questioning and investigations can lead to a disturbance in the doctor-patient relationship.
Harth
W
W
Clinic for Skin Diseases, Erfurt, Germany. wolfgang.harth@t-online.de
Linse
R
R
D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis* / Q000209:etiology; D013997:Time Factors; D014848:Vulvovaginitis / Q000175:diagnosis* / Q000382:microbiology