Corrosive poisoning mimicking cicatricial pemphigoid: Munchausen by proxy

Abstract

Background Munchausen by proxy (MBP) is a severe form of abuse in which a caregiver simulates or fabricates illness in another person, primarily the elderly and children, which can even result in death.

Case We report two siblings who were victims of MBP, one of whom died. A very rare diagnosis, cicatricial pemphigoid was suspected in the 2-year-old girl who was first abused. She was hospitalized twice, for 3 and 4 months, respectively. Her second hospitalization ended with her death. MBP was diagnosed after the second sibling's admission with similar atypical signs and symptoms. It was realized that a household-cleaning product, sodium hydroxide, was administered repeatedly by oral route to the children by their own mother.

Conclusions Physicians must consider the diagnosis of MBP whenever they are confronted with unusual, persistent or recurrent signs and symptoms in a child.