Assessing signs of torture: A review of clinical forensic dermatology.


Journal

Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132

Informations de publication

Date de publication:
08 2022
Historique:
received: 25 08 2020
revised: 09 09 2020
accepted: 11 09 2020
pubmed: 19 9 2020
medline: 22 7 2022
entrez: 18 9 2020
Statut: ppublish

Résumé

It is important for dermatologists and other physicians in refugee-receiving countries to acquire knowledge of forensic dermatology to identify lesions from torture. Review forensic dermatology in cases of torture. In provision of medical assessment and care to refugees and migrants, chronic skin lesions will be the most readily identifiable signs of torture. Beatings are common, with blunt force trauma resulting in postinflammatory hyperpigmentation. Torture burns can be thermal, chemical, or electrothermal, causing distinct lesions determined by the method, duration, and intensity of exposure, and area of skin affected. Sharp instruments inflict a wide range of lesions arising from stabbing/perforation or cuts from knives. Wound healing without medical attention and in unsanitary conditions will affect the scarring process. Lesions from suspension and ligatures may occur alongside scars from other forms of torture. Differential diagnoses include self-inflicted wounds, ethnic scarification, and scars from traditional healing practices. Physicians who may encounter survivors of torture in community or specialist practice would benefit from basic training in forensic dermatology, whereas knowledge of common forms of torture and cultural practices in refugees' countries of origin is important when considering differential diagnoses of skin lesions.

Sections du résumé

BACKGROUND
It is important for dermatologists and other physicians in refugee-receiving countries to acquire knowledge of forensic dermatology to identify lesions from torture.
OBJECTIVE
Review forensic dermatology in cases of torture.
RESULTS
In provision of medical assessment and care to refugees and migrants, chronic skin lesions will be the most readily identifiable signs of torture. Beatings are common, with blunt force trauma resulting in postinflammatory hyperpigmentation. Torture burns can be thermal, chemical, or electrothermal, causing distinct lesions determined by the method, duration, and intensity of exposure, and area of skin affected. Sharp instruments inflict a wide range of lesions arising from stabbing/perforation or cuts from knives. Wound healing without medical attention and in unsanitary conditions will affect the scarring process. Lesions from suspension and ligatures may occur alongside scars from other forms of torture. Differential diagnoses include self-inflicted wounds, ethnic scarification, and scars from traditional healing practices.
CONCLUSION
Physicians who may encounter survivors of torture in community or specialist practice would benefit from basic training in forensic dermatology, whereas knowledge of common forms of torture and cultural practices in refugees' countries of origin is important when considering differential diagnoses of skin lesions.

Identifiants

pubmed: 32946970
pii: S0190-9622(20)32619-0
doi: 10.1016/j.jaad.2020.09.031
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

375-380

Informations de copyright

Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Patrícia D Deps (PD)

Department of Social Medicine, Clinical Research in Dermatology Outpatient Clinic, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil; Laboratoire Anthropologie, Archéologie, Biologie, Université Paris-Saclay, Montigny-le-Bretonneux, France. Electronic address: patricia.deps@ufes.br.

Hugo Pessotti Aborghetti (HP)

Department of Social Medicine, Clinical Research in Dermatology Outpatient Clinic, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.

Taís Loureiro Zambon (TL)

Department of Social Medicine, Clinical Research in Dermatology Outpatient Clinic, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.

Victória Coutinho Costa (VC)

Department of Social Medicine, Clinical Research in Dermatology Outpatient Clinic, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.

Julienne Dadalto Dos Santos (JD)

Department of Social Medicine, Clinical Research in Dermatology Outpatient Clinic, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.

Simon M Collin (SM)

Public Health England, London, United Kingdom.

Philippe Charlier (P)

Laboratoire Anthropologie, Archéologie, Biologie, Université Paris-Saclay, Montigny-le-Bretonneux, France.

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