Case 7

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The 20-month-old toddler in the photograph below was well until the day of admission. His mother reports that she put Ramen noodles in the microwave, turned the microwave on and momentarily left the room. She returned when she heard the child crying. She saw that he had pushed a toy chest in front of the microwave and had hot noodles on his chest and abdomen. He was wearing a one-piece pajama outfit that she quickly removed.

Image description below
Source: A. S. Botash, MD, used with permission

Accessible Version

3 photos: Photo 1: An injury to the skin on a toddler’s chest that is inflamed and irregular, extending to under the axillae on the left, with surrounding redness and a central area of yellowed granulation tissue. Photo 2: Red, blistered injuries to the left hand and anterior distal arm, and on the child’s thumb, thenar eminence, and distal anterior wrist. There is black discoloration on the tip of the 2nd digit, and on the dorsal distal interphalangeal joint (back) of the 3rd digit. Photo 3: An injury to the anterior left thigh with irregular red borders and a central area of yellowed granulation tissue.

Which of the following most accurately reflects the situation?

A. The pattern of the injury is not consistent with a hot liquid scald over pajamas.

B. The timing of the injury is not consistent with the finding of granulation tissue.

C. Approximately 15% of the body surface area is burned.

D. The black discoloration of the fingers indicates superficial partial thickness burns.