Degos disease: a new simulator of non-accidental injury.

[malignant atrophic papulosis]

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 .