A Clue on the Skin: A Systematic Review on Immunohistochemical Analyses of the Ligature Mark

Abstract

Background: A ligature mark is a common injury in cases of hanging or strangulation. Estimation of age and vitality of the ligature mark can be crucial for differentiating antemortem and postmortem wounds and to distinguish between simulated suicidal hanging or accidental strangulation to conceal a crime and not simulated events. The immunohistochemistry has been recommended by several Authors as a reliable tool to determine whether an injury was sustained during life or not. Unfortunately, no general agreement on the immunohistochemical markers to be used has been found among the scientific community. The aim of the study was to detect the type and function of the immunohistochemical markers useful in the assessment of the vitality and age of the ligature marks for routine diagnostics. Methods: Papers available on Pubmed, Scopus, and Web of Science were reviewed according to the PRISMA statement. Results: Only eight papers satisfied all the following inclusion criteria: full texts in English dealing with human ligature marks and immunohistochemistry published on impacted or indexed scientific journals. Conclusions: The assessment of the vitality of a ligature mark is still a challenging topic in forensic science. Under ideal conditions and in compliance with autopsy protocols, the diagnosis of death by hanging or strangulation on fresh bodies can be better supported by autopsy findings other than a ligature mark. The validation of immunohistochemical markers on large series could be of help in doubtful cases and differential diagnoses.

Antigenicity Preservation Is Related to Tissue Characteristics and the Post-Mortem Interval: Immunohistochemical Study and Literature Review

“…In fact, immunohistochemistry is currently used for the dating of lesions and to support the differential diagnostic workflow between vital and post-fatal lesions [ 20 , 21 , 22 ]. Some authors have instead investigated the feasibility of employing immunohistochemistry in the diagnosis of death, achieving in some cases promising results [ 23 , 24 , 25 ]. Since the 1990s, immunohistochemical studies have also been applied in the estimation of the PMI.…”

Myeloperoxydase and CD15 With Glycophorin C Double Staining in the Evaluation of Skin Wound Vitality in Forensic Practice

“…However, as the timing and the intensity of inflammation may be influenced by the type of the trauma and the nature of the lesioned tissue ( 1 , 23 ), these studies cannot be applicable to skin injuries. In skin, we previously studied this marker in surgical and medicolegal wounds ( 5 ), and it was also reported to be an interesting marker in ligature marks ( 6 , 24 ) or for the assessment of the vitality in corpse dismemberment ( 25 ) and in decomposed bodies ( 26 ).…”

Forensic application of epidermal expression of HSP27 and HSP70 for the determination of wound vitality in human compressed neck skin

“…Analyzing the patterned grooves in the neck found at autopsy can help determine the type of hanging or strangulation 1 – 3 . The visibility of neck ligature marks is highly dependent on the nature and texture of the ligature 4 . Soft or hard ligature marks are placed on the neck using a variety of tools, including electrical cords, telephone cords, wires, ropes, belts, and ties 4 – 6 .…”