Differential diagnosis between physical maltreatment and cupping practices in a suspected child abuse case

  • Francesco Lupariello
  • Elena Coppo
  • Ilaria Cavecchia
  • Caterina BoscoEmail author
  • Luana Bonaccurso
  • Antonio Urbino
  • Giancarlo Di Vella
Images in Forensics
Part of the following topical collections:
  1. Topical Collection of Images in Forensics


Physical maltreatment is one of the most common forms of child abuse. Cutaneous injuries often raise the suspicion of child maltreatment. Nevertheless, among health professionals there is still uncertainty in the evaluation of such injuries. In the literature, there are few indications about the most important factors that allow the differentiation of physical abuse findings from signs/lesions that are caused by “folk medicine practices” with similar presentations. We report the case of two brothers who were brought to the Emergency Department of a pediatric hospital by their father because each of them showed one painful, circular and red-purple bruise on their back. Suspecting child abuse, the emergency physicians reported the case to a multidisciplinary unit (dedicated to child abuse). After a careful physical examination, psychological interviews, as well as the evaluation of their medical history, the operators pointed out that the lesions were the result of cupping practices (a form of folk medicine). This case highlights the need for a multidisciplinary approach and demonstrates the importance of a careful evaluation of the cultural background of the family.


Child abuse Folk medicine Cupping Multidisciplinary approach 


Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals undertaken by any of the authors.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Dipartimento di Scienze della Sanità Pubblica e Pediatriche - Sezione di Medicina LegaleUniversità degli Studi di TorinoTorinoItaly
  2. 2.Dipartimento di Pediatria d’Emergenza, Child Abuse Unit“A.O.U. Città della Salute e della Scienza” di TorinoTorinoItaly

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