Case reportLichtenberg figures associated with a high-voltage industrial burn
Section snippets
Case report
A 49-year-old man sustained a 15% total body surface area electric burn. At the time the burn occurred, the patient was working in a team and carried a metallic bar. This bar had clearly touched a railway electrical cable which was just above. The wire was transporting a 25 000 V alternating current. The worker felt backwards and suffered a transient loss of consciousness. Most of the burn was superficial, with only 4% being deep dermal in nature. The localisations of burns were: left lateral
Commentary
Lichtenberg figures are regarded as pathognomonic of lightning injury [2]. Their mechanism remains unclear [2], [4]. The observation of such a figure may have forensic consequences [4], [5] insofar as this finding is considered valuable to confirm the diagnosis of lightning injury [6]. These figures can be seen even in cases of surreptitious lightning strike through a conductive device [7].
The fern-leaf pattern in this observation is comparable with lightning injury observations [2]. Their
Conclusion
To our knowledge, this is the first observation of a Lichtenberg figure in case of high-voltage burn. Seemingly, these figures should no more be considered as a characteristic of lightning injury alone, but instead injury with very high voltage electricity. The report of such figures alone should not signify lightning injury.
Conflict of interest statement
The authors assure that there is no conflict of interest.
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Cited by (10)
Lichtenberg Figures: How a Cutaneous Sign Can Solve Suspicious Death Cases
2022, Wilderness and Environmental MedicineCitation Excerpt :The LFs can be observed after lightning injury or in high-voltage burns. In open areas without a source of high voltage, LFs are pathognomonic for lightning.21 There is a reported case of arborescent pressure-induced vasodilation that was said to mimic LFs.
The various pathological manifestations of a lightning strike exemplified in a single four-fatality incident – A case report and review of a literature
2022, Legal MedicineCitation Excerpt :The other, probably most well-known external injuries, are Lichtenberg figures, that were identified in Case 1 (Fig. 1.). Although keraunographic markings were also reported in some high-voltage electrocution victims [31], the distinctive fern-like patterns are considered pathognomonic for lightning strike injuries. They are not commonly described in victims - frequency of those findings varies in the literature and reaches up to approximately 30% of cases [3,32].
Unusual Lichtenberg figures in a lightning strike's victim: Case report and literature review
2022, Legal MedicineCitation Excerpt :We have only included cases of people struck by natural electrical energy (lightning), excluding high-voltage industrial energy. Only two case reports provided histological findings of these skin areas [16,18], which were also described in one of the two case reports in which two people were hit by an high-voltage industrial current [28,29]. In 1996 Resnik reported a Lichtenberg figure fading in 24 h [16].
LIGHTNI NG STRI KE: A CASE REPORT
2022, Annals of Burns and Fire Disasters