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.
Department of Social Medicine, Clinical Research in Dermatology Outpatient Clinic, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
J Am Acad Dermatol. 2022 Aug;87(2):375-380. doi: 10.1016/j.jaad.2020.09.031. Epub 2020 Sep 16.
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.
对于难民接收国的皮肤科医生和其他医生来说，掌握法医皮肤病学知识以识别酷刑造成的损伤非常重要。
综述酷刑相关的法医皮肤病学。
在为难民和移民提供医疗评估和护理时，慢性皮肤损伤将是最容易识别的酷刑迹象。殴打很常见，钝器伤会导致炎症后色素沉着过度。酷刑烧伤可由热、化学或电热引起，根据方法、暴露时间和强度以及受影响的皮肤面积，导致不同的损伤。锐器会造成刺伤/穿孔或刀割伤引起的广泛损伤。未经医疗处理和在不卫生条件下的伤口愈合会影响瘢痕形成过程。悬挂和结扎造成的损伤可能与其他形式的酷刑造成的瘢痕一起出现。鉴别诊断包括自伤、种族刻痕和传统愈合方法造成的瘢痕。
在社区或专科实践中可能会遇到酷刑幸存者的医生，从法医皮肤病学的基本培训中受益；而在考虑皮肤损伤的鉴别诊断时，了解常见的酷刑形式和难民原籍国的文化习俗非常重要。
