[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Forensic medicine](https://durgical.com/en/forensic-medicine/) › [Asphyxia and physical agents](https://durgical.com/en/forensic-medicine/areas/asphyxia-physical/) › Burns in forensic medicine: patterns and antemortem signs

# Burns in forensic medicine: patterns and antemortem signs

- Finding

The forensic doctor describes the cause, extent and pattern of burns and looks for signs that they happened in life.

Updated Nov 5, 2026

## Key points

- Immersion scald in a child: sharp, symmetrical margins (glove or stocking), no splashes, flexural creases spared: suspect maltreatment.
- Contact burn shaped like the object (iron, grill) or small equal round burns: suggest inflicted injury.
- Vital signs: red halo, blisters with protein-rich fluid and a red, inflamed base.
- Postmortem blisters have a pale base and little fluid; a body burned after death shows no vital reaction.
- Extent is estimated by body surface area (rule of nines in adults; age-based charts in children).

## What it is

Burns are caused by flame, hot liquids (scalds), contact with hot objects, chemicals, electricity or radiation. Forensic medicine asks three questions: what caused them, whether they happened in life and whether the pattern fits the history. Some patterns suggest inflicted injury, above all in children: immersion scalds with sharp, symmetrical edges, contact burns shaped like the object, and small round burns of equal size. Burns sustained in life show a vital reaction: a red margin, blisters with protein-rich fluid and a red base.

## How to tell it apart

- Accidental versus inflicted scald: an accidental spill leaves splashes and irregularity; forced immersion, sharp margins and symmetry.
- Conditions that mimic burns: impetigo, contact dermatitis, congenital dermal melanocytosis, lesions from cultural practices.
- Electrical burns: small, pale, with a raised edge; see the electricity page.
- Antemortem versus postmortem burn: vital reaction, blister contents and histology.

## How to recognise it

- Flame: irregular burns, with soot, singed hair and an upward pattern.
- Spill or splash scald: arrowhead or drip pattern, uneven depth.
- Immersion scald: sharp margins, even depth, flexural creases spared.
- Contact: the exact shape of the hot object, with sharp edges.
- Chemical: diffuse edges, colour depending on the substance, no blisters in some cases.

## How it forms

- Heat denatures proteins and damages the skin in depth according to temperature and contact time.
- In life, inflammation of the margin and plasma leakage form the red halo and protein-rich blisters.
- After death there is no circulation: blisters contain little fluid and there is no inflammatory halo.

## Next step: what to do and document

- Describe the cause, site, extent, depth, pattern and edges of each burn, with scaled photographs.
- Ask and record in the patient's or companion's own words how it happened, and whether the account fits the pattern.
- In children, older or dependent people with a suspicious pattern, examine the whole body, report and activate the protection pathway.
- Keep related clothing and objects (garments, containers) with a chain of custody if a crime is suspected.
- In the expert report, state the incapacity and possible sequelae, such as disfigurement or loss of function.

## Common mistakes

- Accepting an accident history without checking that the burn pattern fits it.
- Not examining the whole body of a burned child for other signs of maltreatment.
- Confusing postmortem blisters or skin slippage from decomposition with burns in life.
- Describing extent without a reproducible method.

## Test yourself

Think of the answer, then tap the question to see it.

## Which scald pattern suggests child maltreatment?

An immersion scald with sharp, symmetrical glove or stocking margins, no splashes and the flexural creases spared.

## Which signs show that a burn happened in life?

A red inflammatory halo and blisters with protein-rich fluid and a red base; postmortem blisters have a pale base and little fluid.

## What do several small round burns of the same size suggest?

Inflicted contact burns, for example with a cigarette; they call for a full-body examination and a report.

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## Elsewhere in DurgiPedia

- [Thermal injury: burns, hyperthermia and hypothermia](https://durgical.com/en/general-pathology/thermal-injury-burns-hyperthermia-and-hypothermia/)
- [Mandatory reporting: public health, violence and abuse](https://durgical.com/en/medical-ethics/mandatory-reporting-public-health-violence-and-abuse/)

## Connections

## Related 6

- [Deaths in fires: soot, carboxyhaemoglobin and heat artefacts](https://durgical.com/en/forensic-medicine/deaths-in-fires-soot-carboxyhaemoglobin-and-heat-artefacts/)
- [Electrical injury and lightning](https://durgical.com/en/forensic-medicine/electrical-injury-and-lightning/)
- [Vital reaction: was the wound made in life?](https://durgical.com/en/forensic-medicine/vital-reaction-was-the-wound-made-in-life/)
- [Child maltreatment: signs that should raise concern](https://durgical.com/en/forensic-medicine/child-maltreatment-signs-that-should-raise-concern/)
- [Examining a living victim of injury (lesiones personales)](https://durgical.com/en/forensic-medicine/examining-a-living-victim-of-injury/)
- [Medico-legal sequelae: deformity, functional impairment, loss](https://durgical.com/en/forensic-medicine/medico-legal-sequelae-deformity-functional-impairment-loss/)

## Related conditions 3

- [Burns (thermal, chemical, electrical; inhalation injury)](https://durgical.com/en/conditions/burns/)
- [Child maltreatment (physical abuse, abusive head trauma, neglect)](https://durgical.com/en/conditions/child-maltreatment/)
- [Elder abuse and neglect](https://durgical.com/en/conditions/elder-abuse-and-neglect/)

[← All of forensic medicine](https://durgical.com/en/forensic-medicine/)

Educational content on forensic and legal medicine; not legal advice and no substitute for the technical guides of Colombia's National Institute of Legal Medicine and Forensic Sciences. Laws change: each page links the official text and says when it was last checked. For a real case, follow the guide in force and ask the competent authority.

Sources: [Cause of Death in Charred Bodies: Reflections and Operational Insights Based on a Large Cases Study](https://pmc.ncbi.nlm.nih.gov/articles/PMC9407296/) (Diagnostics, PubMed Central, 2022); [Inhalation Injury](https://www.ncbi.nlm.nih.gov/books/NBK513261/) (StatPearls, NCBI Bookshelf, 2023).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/forensic-medicine/burns-in-forensic-medicine-patterns-and-antemortem-signs/