Child abuse or self-immolation? A case report

Non-accidental burns may not be detected unless a complete history of the accident and a detailed physical examination is obtained. Self-inflicted burns are a regular source of admission to burn units.
An 11 year old boy with multiple localized burn injuries was brought to the emergency department of burn hospital by his mother. The lesions were in different symmetrical shapes on the posterior forearms. The grade of burn injury was 2B-3 and the injuries had happened 12 hours ago. The mother claimed that his son decided to punish himself following frequent blame from the family because of lying thus he made knife blade and spoon hot over the stove and put them on his forearms for several times. In further history taking the mother said that his son is a case of attention deficit and hyperactivity disorder (ADHD).
Self-immolation in psychotic children happens with different motivations, thus appropriate history taking, physical examination and psychiatric evaluation can lead us to correct diagnose and take the best decision. Children who suffer from a diagnosable mental illness can benefit from an appropriate treatment and be protected from further injuries.