Blister on Toddler's Foot: Burn? Blistering Disease? Abuse?

An 18-month-old boy was brought to an indigent care clinic with a blister on his foot. His mother stated that she had cared for the child the prior evening and that no blister was present at that time. She reported that her teenage daughter had dressed the boy before the mother brought him to daycare that morning. The stated concern was that something had happened to the child at the daycare center to cause the injury.

When the mother was pressed for more details, she remembered that the child was crying as she left the house and also as she left him at daycare. This was not unusual but, in retrospect, she thought the child had been crying more than was customary.

A call was made to the daycare center. The daycare worker commented that the child had been more irritable than usual all day. The worker also recalled that the child had fallen asleep at naptime with his shoes on. There was no history of trauma. 

Do you think this child has been abused?

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