title: Degos disease: a new simulator of non-accidental injury.
abstract: Recent high-profile cases have made paediatricians very aware of the serious implications of either missing or wrongly diagnosing non-accidental injury. Subdural fluid collections in non-mobile infants usually represent haemorrhage caused by non-accidental injury. We report a 6-month-old male who presented to the Accident and Emergency Department of Birmingham Heartlands Hospital with bilateral subdural fluid collections and skin ulcers resembling cigarette burns. Non-accidental injury was considered to be the most likely diagnosis. However, while under observation in hospital, the child's neurological condition deteriorated with progressive cerebral infarctions, and serial photographs of the skin lesions showed failure to heal. The revised diagnosis, confirmed histologically, was Degos disease, an extremely rare and often fatal occlusive vasculopathy. The child was treated palliatively and died 8 weeks after presentation. This report informs doctors of a new simulator of non-accidental injury to be considered in infants with otherwise unexplained subdural fluid collections.
authors: Department of Dermatology, Birmingham Children's Hospital, Birmingham, UK. celia.moss@bch.nhs.uk
authors: Celia
authors: C
authors: Moss
authors: Evangeline
authors: E
authors: Wassmer
authors: Geoff
authors: G
authors: Debelle
authors: Scott
authors: S
authors: Hackett
authors: Helen
authors: H
authors: Goodyear
authors: Roger
authors: R
authors: Malcomson
authors: Clive
authors: C
authors: Ryder
authors: Spyros
authors: S
authors: Sgouros
authors: Hossain
authors: H
authors: Shahidullah
mesh_terms: D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D007223:Infant; D008297:Male; D054853:Malignant Atrophic Papulosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014947:Wounds and Injuries / Q000175:diagnosis