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Esposito-Fava A, Marchand E, Gauchotte G. Skin injuries in forensic histopathology: a descriptive study. Forensic Sci Med Pathol 2024; 20:51-58. [PMID: 36997811 DOI: 10.1007/s12024-023-00610-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2023] [Indexed: 04/01/2023]
Abstract
Histopathology is commonly used in forensic medicine. Only few studies are available in the literature about the correlation between skin wounds histopathology and survival time or other medicolegal data. The aim of this study was to illustrate the usefulness of histopathological analysis of skin wounds in forensic daily practice and to evaluate its correlation with the clinical and police investigation data. In this single-center, retrospective, and descriptive study, we included 198 forensic pathology cases, from the files of the Legal Medicine and Biopathology Departments of the University Hospital of Nancy, with a total of 554 skin samples. Basing on the police investigations (n = 43), the median survival time between the main related trauma and death was 83 min. The histopathological analysis concluded to 2% of post-mortem lesions (absence of hemorrhage) and 55% of perimortem or undetermined lesions (hemorrhage without inflammation); 8% of the lesions had an estimated time interval between more than 10 min and several hours, 22% between several hours and several days, and 14% between several days and several weeks. Histopathological dating was statistically associated with wound location (p < 0.01), the type of injury, hypothermia, positive toxicology, histopathological hepatic lesions, and survival time (p < 0.001). In conclusion, the histopathological analysis of skin wounds allowed to propose a survival time in almost half of cases, with a significant correlation with the police investigation-based estimation of survival time, but also other parameters such as wound location or toxicology. It however lacks of accuracy, and further studies are needed to develop new markers, notably based on immunohistochemistry.
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Affiliation(s)
- Aude Esposito-Fava
- Department of Legal Medicine, CHRU Nancy, Rue du Morvan, 54511, Vandoeuvre-Lès-Nancy, France
| | - Elodie Marchand
- Department of Legal Medicine, CHRU Nancy, Rue du Morvan, 54511, Vandoeuvre-Lès-Nancy, France
| | - Guillaume Gauchotte
- Department of Legal Medicine, CHRU Nancy, Rue du Morvan, 54511, Vandoeuvre-Lès-Nancy, France.
- Department of Biopathology, CHRU Nancy - ICL, BBB, Vandoeuvre-Lès-Nancy, France.
- Faculty of Medicine, INSERM U1256, NGERE, Université de Lorraine, Vandoeuvre-Les-Nancy, France.
- Centre de Ressources Biologiques, CHRU, BB-0033-00035, Nancy, France.
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Tomassini L, Lancia M, Scendoni R, Manta AM, Fruttini D, Terribile E, Gambelunghe C. Dating Skin Lesions of Forensic Interest by Immunohistochemistry and Immunofluorescence Techniques: A Scoping Literature Review. Diagnostics (Basel) 2024; 14:168. [PMID: 38248045 PMCID: PMC10814027 DOI: 10.3390/diagnostics14020168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Wound age estimation is a significant issue in forensic pathology. Although various methods have been evaluated, no gold standard system or model has been proposed, and accurate injury time estimation is still challenging. The distinction between vital skin wounds-i.e., ante-mortem lesions-and skin alterations that occur after death is a crucial goal in forensic pathology. Once the vitality of the wound has been confirmed, the assessment of the post-trauma interval (PTI) is also fundamental in establishing the causal relationship between the traumatic event and death. The most frequently used techniques in research studies are biochemistry, molecular biology, and immunohistochemistry (IHC). Biochemical methods take advantage of the chemical and physical techniques. A systematic literature search of studies started on 18 February 2023. The search was conducted in the main databases for biomedical literature, i.e., PubMed and Scopus, for papers published between 1973 and 2022, focusing on different techniques of immunohistochemistry and immunofluorescence (IF) for estimating the PTI of skin wounds. The present study involves a comprehensive and structured analysis of the existing literature to provide a detailed and comprehensive overview of the different IHC techniques used to date skin lesions, synthesize the available evidence, critically evaluate the methodologies, and eventually draw meaningful conclusions about the reliability and effectiveness of the different markers that have been discovered and used in wound age estimation.
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Affiliation(s)
- Luca Tomassini
- International School of Advanced Studies, University of Camerino, 62032 Camerino, Italy
| | - Massimo Lancia
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, Piazza Lucio Severi, 06132 Perugia, Italy; (M.L.); (E.T.); (C.G.)
| | - Roberto Scendoni
- Department of Law, Institute of Legal Medicine, University of Macerata, 62100 Macerata, Italy;
| | - Anna Maria Manta
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University, 00185 Rome, Italy;
| | - Daniela Fruttini
- Section of Internal Medicine and Endocrine and Metabolic Sciences, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy;
| | - Erika Terribile
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, Piazza Lucio Severi, 06132 Perugia, Italy; (M.L.); (E.T.); (C.G.)
| | - Cristiana Gambelunghe
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, Piazza Lucio Severi, 06132 Perugia, Italy; (M.L.); (E.T.); (C.G.)
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3
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Ye MY, Xu D, Liu JC, Lyu HP, Xue Y, He JT, Huang HY, Zhang KK, Xie XL, Wang Q. IL-6 and IL-20 as potential markers for vitality of skin contusion. J Forensic Leg Med 2018; 59:8-12. [PMID: 30059828 DOI: 10.1016/j.jflm.2018.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 07/16/2018] [Accepted: 07/21/2018] [Indexed: 01/02/2023]
Abstract
The detection of vitality of wounds is very important in forensic practice. This study is performed using quantitative real-time reverse transcriptase polymerase chain reaction (RT-qPCR) in both mouse and human skin wounds for the application of IL-6 and IL-20 in order to differentiate intravital wounds from postmortem wounds. RT-qPCR analysis of contused mouse skin showed that increased IL-6 and IL-20 mRNA levels were found in comparison to intact skin tissues. The increased mRNA expressions of IL-6 and IL-20 were observed until 72 h after death in contused mouse skin, whereas there were no marked changes in these two cytokines in the postmortem contusion group. The alterations of IL-6 and IL-20 can also be detected in human skin wound samples. These finding suggest that mRNA levels of IL-6 and IL-20 might be used as potential markers for vital reaction.
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Affiliation(s)
- Ming-Yuan Ye
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Di Xu
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Jin-Cen Liu
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Hao-Pin Lyu
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Ye Xue
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Jie-Tao He
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Hong-Yan Huang
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Kai-Kai Zhang
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Xiao-Li Xie
- Department of Toxicology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China.
| | - Qi Wang
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China.
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Casse JM, Martrille L, Vignaud JM, Gauchotte G. Skin wounds vitality markers in forensic pathology: An updated review. MEDICINE, SCIENCE, AND THE LAW 2016; 56:128-37. [PMID: 26101444 DOI: 10.1177/0025802415590175] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Wound age evaluation is one of the most challenging issues in forensic pathology. In the first minutes or hours, standard histological examination may not determine whether the wound was inflicted in the pre- or post-mortem period. While red blood cell infiltration is classically considered as a sign of vital reaction, several studies have shown that extravasation of blood cells may also occur after death and cannot be used as a reliable marker in the diagnosis of wound vitality. Numerous studies about wound vitality are available in the literature. They have evaluated markers involved in coagulation or inflammation, using various methods such as enzymology, molecular biology or immunohistochemistry. In this update, we first introduce some methodological principles. Then, we review the main studies available in the literature. Immunohistochemistry seems to be the most valuable method, given its easy application and the possibility to analyse the localization of the molecules of interest. Some markers are promising, such as CD15, TNFα, IL-6, IL-1β, TGFα or TGFβ1. Prior to their application in daily practice, these early results need to be confirmed with other studies, conducted by independent teams and integrating multiple controls. Most notably, the antibodies have to be tested in numerous post-mortem wounds. Indeed, a critical risk of overexpression in post-mortem wounds is present. Some promising markers have been later invalidated because of post-mortem false positivity. Finally, optimal sensitivity and specificity values could probably be reached by combining several markers, validated by large groups of pre- and post-mortem wounds.
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Affiliation(s)
- Jean-Matthieu Casse
- Department of Pathology, CHU Nancy; INSERM U954, Faculty of Medicine, Université de Lorraine, France
| | - Laurent Martrille
- Department of Legal Medicine, CHU Nancy; Université de Lorraine, France
| | - Jean-Michel Vignaud
- Department of Pathology, CHU Nancy; INSERM U954, Faculty of Medicine, Université de Lorraine, France
| | - Guillaume Gauchotte
- Department of Pathology, CHU Nancy; INSERM U954, Faculty of Medicine, Université de Lorraine, France
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Gauchotte G, Martrille L, Plénat F, Vignaud JM. Les marqueurs de vitalité des blessures en pathologie médicolégale. Ann Pathol 2013; 33:93-101. [DOI: 10.1016/j.annpat.2013.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 01/18/2013] [Accepted: 02/11/2013] [Indexed: 10/27/2022]
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Cecchi R. Estimating wound age: looking into the future. Int J Legal Med 2010; 124:523-36. [DOI: 10.1007/s00414-010-0505-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 08/10/2010] [Indexed: 12/16/2022]
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Maeno Y, Mori Y, Iwasa M, Inoue H. Estimation of local vital reactions in severely burned tissues of guinea pig skin using C3a or C3a desArg as a marker. Forensic Sci Int 1993; 61:43-52. [PMID: 8225139 DOI: 10.1016/0379-0738(93)90248-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We observed changes in levels of anaphylatoxin C3a and/or its desArg (C3a/C3a desArg) peptides in the local site of severely burned skin tissues of guinea pigs using immuno-Western blotting methods. The C3a/C3a desArg peptides, which were probably generated during complement activation, were detected at significant levels from 30 min to 72 h following burn injury in an area limited to 3 mm from the wound edge. Levels of these peptides showed a tendency to be highest in that area 24 h after burn infliction. In postmortem injuries, C3a/C3a desArg peptides could not be detected. These peptides were detected in antemortem wounds up to at least 2 days at 22 degrees C and up to 3 days at 4 degrees C after death, although decreases in levels were found. Lower concentrations of these peptides were also found in postmortem burns in which postmortem hypostasis appeared strongly. These results suggest that, except for injuries of the area with obvious postmortem hypostasis, detection of C3a/C3a desArg can be useful for estimation of vital reactions in many kinds of wounds during inflammation.
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Affiliation(s)
- Y Maeno
- Department of Legal Medicine, University Medical School, Nagoya, Japan
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Maeno Y, Mori Y, Iwasa M, Inoue H, Takabe F. Complement component C3a or C3a desArg as a new marker for estimation of local vital reactions in incised skin wounds. Forensic Sci Int 1992; 55:37-44. [PMID: 1511937 DOI: 10.1016/0379-0738(92)90092-b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The anaphylatoxin C3a or its desArg form (C3a/desArg) generated during complement activation could be detected in the vicinity of incised skin wounds of guinea pigs using immunoblotting methods. The C3a/desArg peptides were detectable immediately after injury in local sites up to 3 mm from the wound edge. In subsequent determinations of up to at least 3-day-old antemortem wounds, the maximum concentration of these peptides was largely localized up to 6 mm from the wound edge at 2 h after injury. In postmortem wounds, however, these peptides were undetectable. When they were released in antemortem wounded tissues they could be detected up to 1 day at 22 degrees C after death. These results suggest that the detection of C3a/desArg in wounds using immunoblotting methods can be useful for distinguishing ante- from postmortem wounds.
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Affiliation(s)
- Y Maeno
- Department of Legal Medicine, Nagoya City University Medical School, Japan
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