Differentiation between bruises and putrefactive discolorations of the skin by immunological analysis of glycophorin A

Kibayashi, Kazuhiko; Hamada, Kisei; K, Honjyo; Tsunenari, Shigeyuki

doi:10.1016/0379-0738(93)90219-z

Cited by 16 publications

(8 citation statements)

References 2 publications

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“…Immunological methods have demonstrated the usefulness of glycophorin A, a constituent of red blood cell membranes, as a marker to diVerentiate between true bruising and putrefactive discolouration. 32 Although haemoglobin pigments readily filter through blood vessels, erythrocyte membranes do so less easily because of their molecular size. Therefore, bruises will contain a greater amount of erythrocyte membrane material than areas of discolouration resulting from putrefactive change.…”

Section: Deathmentioning

confidence: 99%

Interpreting bruises at necropsy

Vanezis

2001

Journal of Clinical Pathology

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The accurate interpretation of bruising at necropsy is essential to understanding how a victim has been injured and assists the pathologist in a reliable reconstruction of the events leading to death. It is essential not only to assess the mechanism of production of a bruise, taking into account the type of impacting surface and the magnitude of force used, but also to estimate when the injury was caused. An account is given of the various methods used in the examination of bruises, particularly with respect to aging, as well as the factors that may aVect their appearance. DiVerentiation from artefacts resulting from postmortem changes is also discussed in some detail. (J Clin Pathol 2001;54:348-355) Keywords: bruising; necropsy; time of death; cause of death The interpretation of bruising for forensic purposes requires the pathologist to bear in mind the following three fundamental questions: + Is the discolouration seen a bruise? + When was it caused? + How was it caused?A succinct definition of a bruise is that it is a collection of blood, visible to the naked eye as an area of discolouration, which has extravasated into the surrounding tissues after vascular disruption, principally as a result of trauma or occasionally spontaneously, as a result of a disease process. Typically, bruises are caused by blunt trauma, although they may be associated with any type of impact and can accompany many diVerent types of wounds. Thus, they can provide much information with regard to their causation and can assist with the reconstruction of events leading to death.Furthermore, when an injury is inflicted and blood extravasates from injured blood vessels the resultant bruising may be: + Located at the area of impact and visible shortly after infliction of the injury. + Located at the area of impact area but delayed in appearance. + Located at a site away from the impact area and result from tracking of blood from the impact area. The word bruise is often used synonymously with the term haematoma and ecchymosis (or ecchymoma). Contusion is also another frequently used term, particularly in relation to internal trauma.Although bruising is most often thought of as an extravasation of blood intradermally or subcutaneously, bruises can occur almost anywhere in the body. Factors that influence the development and appearance of bruisesThere are many variables that influence the development and absorption of bruises, as well as their appearance and extent of spread, thus adding to the diYculty in their interpretation.Bruising occurs more easily where there is loose tissue-for example, over the eyebrowrather than where the skin is more strongly supported. It also occurs more readily where there is an excess of subcutaneous fat. Because there is a greater skin deposition of fat in women, they tend to bruise more easily than do men.The type of surface and force that impacts on the body will have a great eVect on the intensity, size, shape, and pattern of the resultant bruising.In infants and the elderly bruising tends to o...

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Section: Deathmentioning

confidence: 99%

Interpreting bruises at necropsy

Vanezis

2001

Journal of Clinical Pathology

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“…This antigen was well researched previously and found to be useful to differentiate between bruises and putrefactive discoloration. The studies showed its absence in hypostasis; hence, its use in differentiating between bruises and hypostasis in the case report is questionable (9).…”

Section: Discussionmentioning

confidence: 99%

Postmortem Changes of Female External Genitalia and Their Importance in Suspected Sexual Abuse

Alsaif

Al-Farayedhi

Al-Shamsi

et al. 2020

Journal of Forensic Sciences

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Examination of the female external genitalia to assess for sexual abuse is performed in living individuals, and the interpretation of the findings is based on evidence‐based studies. However, in the deceased, no such studies are available, and postmortem changes could present as suspicious findings that can be mistaken for trauma. Patches of discoloration in the hymen were reported previously in one case as hypostasis (i.e., livor and lividity), and based on this finding, it was listed as a finding that is not associated with trauma. This was a retrospective study that was conducted in the Center of Forensic and Legal Medicine in Dammam, Saudi Arabia over a 4‐year period. The study included 30 deceased women in whom photographic documentation of their external genitalia was assessed for postmortem changes. The postmortem interval ranged from less than 24 h to more than 100 days, and the ages of these deceased women were in the 20–40 year‐old age group. In cases where the hymen, vagina, and/or fossa navicularis were clearly visible, none of these areas showed any hypostatic discoloration. A comparison between antemortem and postmortem appearance of the hymen in one case clearly showed the absence of hypostatic changes in the hymen. In conclusion, any discoloration of the external genitalia that is detected in a female decedent requires serious consideration.

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“…Only two authors have looked into the possibility of verifying within decomposed tissues the presence of haemorrhaging by looking for red blood cell residues (the Glycophorin antigen). Kibayashi et al 11 have used Glycophorin for differentiating bruises from putrefied discoloured skin; in their study they showed the presence of Glycophorin A in a putrefied lesion 10 days after death and its absence in postmortem hypostases or putrefactive discolourations. Tabata et al, 12 on the other hand, used immunohistochemical stains for Glycophorin on 91 decomposed specimens (from 12 hours to 3 months) with and without bleeding, and demonstrated the utility of Glycophorin A in differentiating between bleeding and postmortem haemoglobin diffusion from blood vessels in decomposed bodies.…”

Section: Introductionmentioning

confidence: 99%

The use of the anti-Glycophorin a antibody in the detection of red blood cell residues in human soft tissue lesions decomposed in air and water: a pilot study

Taborelli¹,

Andreola²,

Giancamillo

et al. 2011

Med Sci Law

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The distinction between antemortem and postmortem wounds is one of the most important medico-legal problems. In fresh cadavers the macroscopic examination of haemorrhagic infiltration can be sufficient to reveal the vitality of a wound but in more difficult cases (putrefied corpses) histological and histochemical analyses need to be performed. The scope of this study was to detect the vitality of soft tissue samples in an advanced state of putrefaction using a monoclonal anti-human Glycoforin A antibody in order to evaluate the presence of red blood cells or red blood cell residues. Samples of skin wounds were taken from cadavers with a known time survival between trauma and death, and then submitted to a simulated putrefaction procedure. The skin samples were left to decompose for 30 days in air and in water and analyzed at a time interval of 3-6-15-30 days. These samples were stained with haematoxylin eosin stain, trichrome stain and with immunohistochemical stains. Results showed that in the air red blood cells could be seen for up to six days and granular deposits of Glycophorin reactive material for up to 15 days whereas no red blood cells were recognizable after 30 days. In water red cell putrefaction (or non-detection) was faster than in the air: after six days only amorphous granular deposits slightly reactive to Glycophorin could be seen. Nonetheless results showed that extravasated red blood cell residues can still be detected in skin bruises left to decompose in air and water, for up to at least 15 days in the open air and one week in water.

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Differentiation between bruises and putrefactive discolorations of the skin by immunological analysis of glycophorin A

Cited by 16 publications

References 2 publications

Interpreting bruises at necropsy

Interpreting bruises at necropsy

Postmortem Changes of Female External Genitalia and Their Importance in Suspected Sexual Abuse

The use of the anti-Glycophorin a antibody in the detection of red blood cell residues in human soft tissue lesions decomposed in air and water: a pilot study

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