A 2-year-old girl was brought to a sexual abuse clinic by a social worker and the child’s foster mother. The child had been placed in the foster home 2 days earlier and the foster mother was concerned about a reported history of sexual abuse. The only known history was that the child was from a distant county where there had been allegations of sexual abuse. The family had fled their home when they learned that they were being investigated and had been on the run for 6 months when they were arrested on unrelated charges.
The genital exam was normal and the only physical abnormality was a facial scar (Figure). A phone call to child protective services in the county of origin revealed no useful information other than that the report of abuse had been an anonymous call.
Has this child been abused or is this case a child abuse mimic?