Dermatological findings after alleged torture.

Macroscopic changes The significance of skin lesions is mostly related to the documentation of the history of torture. Acute lesions may give health problems, for example pain and secondary infections, including problems with healing, especially when located in an area with venous or arterial insufficiency. Scars located close to a joint may induce contracture, decreased mobility of the joint and pain during activity. Apart from this, scars seldom inconvenience the patient, although they can sometimes be of cosmetic importance since they may be a reminder of the torture and add to the changed sense of identity induced by torture. A detailed history of the alleged torture and of the symptoms it induced is important in order to evaluate the significance of the observed lesions on the skin. Information about the position of the victim and of the torturer during the torture is particularly important, as well as information about the shape of instruments in contact with the skin. In cases with no or uncharacteristic lesions, a characteristic history may be the only support to the allegation of torture, as for example in some cases of electrical torture. Also a history of skin diseases and nontorture-related lesions are of importance. The examination should include the entire body surface to detect signs of: