Statureforage and Weightforage percentiles

record #

Published May 30, 2000 (modified 11/21/00). SOURCE: Developed by the National Center for Health Statistics in the National Center for Chronic Disease Prevention and http://www.cdc.gov/growthcharts

collaboration with Health Promotio(n2000).

SAFER' HEALTHIER'PEOPLE'

Figure 24-25 B, NCHS percentiles for girls.

Published May 30, 2000 (modified 11/21/00). SOURCE: Developed by the National Center for Health Statistics in the National Center for Chronic Disease Prevention and http://www.cdc.gov/growthcharts

collaboration with Health Promotio(n2000).

SAFER' HEALTHIER'PEOPLE'

Figure 24-25 B, NCHS percentiles for girls.

Thoracic Cutaneous Hemangioma
Figure 24-27 Seborrheic dermatitis.

Figure 24-26 Seborrheic dermatitis, or cradle cap.

Figure 24-28 Infantile eczema.

Figure 24-29 Atopic dermatitis.

Figure 24-30 Atopic pleat.

excessively stretchy may be an indication of Ehlers-Danlos syndrome, which is a combination of hyperelasticity of skin with joint laxity and easy dislocation and with easy bruisability. Most forms of Ehlers-Danlos syndrome are inherited through autosomal dominance. Therefore, when these features are found in the infant, both parents should be examined.

Is there any evidence of physical child abuse? Are any bruises, welts, lacerations, or unusual scars present? Inspect the buttocks and lower back for evidence of bruises. Paired, crescent-shaped bruises facing each other on any part of the body may represent human bite marks. Bite marks should be suspected when ecchymosis, lacerations, or abrasions are found in any oval shape. Tooth marks by the canine teeth are the most prominent part of a bite. Bites made by animals tear the flesh;bites made by humans crush the flesh. The distance between the maxillary canine teeth in a child is less than 1.2 inches (3 cm);in an adult, it is greater. Figure 24-31 shows a human bite wound. Notice that the intercanine distance is greater than 3 cm.

Is there evidence of traumatic alopecia from pulling out of the hair? The damaged hair is broken at various lengths. Are small, circular, punched-out lesions of uniform size present? These may represent cigarette burns. A large circular-type burn on the buttocks and thighs may result from the infant's immersion in scalding water. Inflicted tap water scalds are the most common type of nonaccidental burn injury. The most common sites include the perineum or extremities. The child pictured in Figure 24-32 has first- and second-degree burns on the penis, thighs, and inguinal and suprapubic areas. The buttocks and sacrum were spared. These burns were caused by holding the child under hot water from the faucet. Burns by a hot object are the second most common type of inflicted burns. A well-circumscribed affected area with the outline of the hot object used is commonly seen. Figure 24-33 shows the typical appearance of specific types of burns. The diagnosis of physical child abuse is especially important in the first 6 months of life because the risk of a fatal outcome is very high if the diagnosis is missed. In a case of suspected child abuse, the clinician must consider possible organic or accidental causes for the findings, such as platelet deficiency with an unusual number of bruises. However, if child abuse is suspected, health authorities must be notified.

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