Electrical injury and lightning
- Finding
Electricity leaves an entry mark and sometimes an exit mark; low voltage on wet skin may leave none at all.
What it is
Electrical injury happens when the body becomes part of a circuit. The typical low-voltage electrical mark is a small, round, pale lesion with a raised edge and a depressed centre at the contact point; the exit mark is usually on the feet or hands. With low voltage, death is usually from ventricular fibrillation and the mark may be absent if the skin was wet or the contact broad. High voltage causes arc burns, deep muscle injury and falls. Lightning is an extremely brief discharge of enormous voltage: it may leave Lichtenberg figures, burns and torn clothing, or no mark at all.
How to tell it apart
- Electrical mark versus ordinary burn: the electrical one is small, pale, with a raised edge and sits at the contact point.
- Lichtenberg figures versus blunt injury: they are transient erythema, without haemorrhage, fading within hours.
- Lightning versus assault: torn clothing and a body in a field may suggest an attack; look for burns and figures, and check the weather.
- Electrocution without a mark: the diagnosis rests on the scene, the device and exclusion of other causes.
How to recognise it
- Entry mark: a round, pale or greyish lesion with a raised edge and a depressed centre; may carry metal deposits from the conductor.
- Exit mark: often on the soles or hands, sometimes as a wound with everted edges.
- High voltage: extensive burns, local charring, multiple pinpoint spark lesions.
- Lightning: fern-shaped Lichtenberg figures, linear or pinpoint burns, torn clothing and footwear.
- Death in a bathtub or with water: the mark may be entirely absent.
How it forms
- Current crossing the heart, as on a hand-to-hand or hand-to-foot path, can cause ventricular fibrillation.
- Skin resistance turns current into heat at the contact point and produces the mark.
- High voltage arcs before contact and generates intense heat, blast and deep tissue destruction.
Low voltage, high voltage and lightning
| Aspect | Low voltage | High voltage | Lightning |
|---|---|---|---|
| Skin lesion | Small pale mark, raised edge; may be absent | Arc burns, charring, multiple sparks | Lichtenberg figures, linear or pinpoint burns; may be absent |
| Main mechanism of death | Ventricular fibrillation | Burns, deep tissue injury, falls | Cardiac and respiratory arrest |
| Typical setting | Home, appliances and cables | Work on power lines | Open ground during a storm |
Next step: what to do and document
- Confirm the power is off before approaching; record the device, cable, moisture and body position.
- Look for and photograph with a scale the entry and exit marks, including palms, fingers and soles.
- Take skin samples from the marks for histology if an autopsy is done, and keep the device with a chain of custody.
- In a lightning death, record the time, place and weather, and examine the clothing and metal objects.
- In a survivor, document the injuries and refer for cardiac monitoring and assessment of deep injury.
Common mistakes
- Approaching the victim without confirming that the power source is off.
- Ruling out electrocution because there is no visible mark.
- Taking Lichtenberg figures for bruises or burns.
- Not keeping the device or cable involved for technical inspection.
Test yourself
Think of the answer, then tap the question to see it.
What does the typical low-voltage electrical mark look like?
A small, round, pale lesion with a raised edge and a depressed centre, at the point of contact with the conductor.
Does the absence of an electrical mark rule out electrocution?
No. With wet skin, broad contact or in a bathtub the mark may be absent; the diagnosis rests on the scene and exclusion of other causes.
What are Lichtenberg figures?
Transient fern-shaped erythema that appears after a lightning strike and fades within hours; it is not a burn and is not seen in every case.
What is the most common mechanism of death with low-voltage current?
Ventricular fibrillation, especially when the current crosses the heart, as on a hand-to-hand or hand-to-foot path.
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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: Electro-Amputation of Lower Limbs Due to a High-Voltage Shock: Report of an Unusual Case (Cureus, PubMed Central, 2024); Lichtenberg figures: morphological findings (Forensic Science, Medicine and Pathology, PubMed Central, 2023).
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