A study of perceptions of facial hemangiomas in professionals involved in child abuse surveillance

Facial hemangiomas are common benign tumors of infancy. They can mimic the appearance of bruises and parents report false accusations of child abuse by strangers. We investigated perceptions of facial hemangiomas in two professional groups involved in child abuse surveillance. Thirty health visitors and 30 primary school teachers were sent a clinical case questionnaire about a child with an involuting facial hemangioma with a color photograph of the lesion. Nineteen health visitors (63%) and 18 primary school teachers (60%) responded. Seventy-four percent of the health visitors and 11% of the teachers correctly diagnosed a hemangioma. Fifty percent of the teachers were unable to decide on a diagnosis. However, only one health visitor (5%) and one teacher (5%) thought that the lesion was a nonaccidental injury and would involve a child protection advisor. About one-third of health visitors and one-third of teachers expressed concerns that the child could suffer psychologically from teasing by peers at school and about one-third of health visitors were also concerned about the psychological effects of the lesion on the child's parents. Health visitors and teachers were most unlikely to mistake the facial hemangioma in this study for a nonaccidental injury.