BACKGROUND Mongolian spots, especially when seen in atypical areas, are of great importance in forensic medicine as they can be confused with the bruising and marks that are one of the most important skin findings of abuse. This confusion could cause a misdiagnosis of abuse. Several skin findings are known to resemble the marks of physical and sexual abuse. However, in child abuse, there is the question to be considered of risk factors of the child, parents, and family. CASE SUMMARY The case is here presented of an infant with retarded development and a Mongolian spot among findings mimicking physical abuse. As there were severe clinical findings on presentation which conflicted with the anamnesis taken from the mother, a diagnosis of shaken baby syndrome was made first. As the medical records were incomplete, it was difficult to decide on the point of child abuse for this infant who was brought to the clinic with head trauma. CONCLUSİONS Together with retarded development, Mongolian spots, which are not given much importance by physicians, could be a risk factor leading to child abuse.

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