The histopathological diagnosis of the electrical mark is hampered by the morphological overlap with thermal burns and abrasions and by the absence of standardized immunohistochemical criteria. This study aimed to develop and preliminarily evaluate an integrated histological and immunohistochemical protocol for the microscopic diagnosis of documented electrocution. Twenty-four full-thickness cutaneous samples from forensic cases with documented electrocution were stained with hematoxylin-eosin and processed for immunohistochemistry with Cytokeratin AE1/AE3. Six representative cases were also stained with HSP27, HSP70, and HSP90 antibodies. Histological findings were summarized as frequencies with exact 95
Extreme heat produces a substantial mortality burden that is captured through two incompletely connected systems: individual medicolegal investigation and population-level statistical attribution. This review defines the distinct causal constructs measured by these systems and proposes a practical framework for integrating forensic diagnosis, death certification, and excess-mortality surveillance. A structured narrative review of the published literature was conducted from database inception through 17 July 2026. Evidence was integrated across heat-illness pathophysiology, forensic scene investigation, autopsy and ancillary testing, differential diagnosis, death certification and coding, vulnerability, occupational fatalities, and temperature-mortality modelling. Particular emphasis was placed on reconciling individual medicolegal case ascertainment with epidemiological estimates of excess mortality. Reporting was guided by the Scale for the Assessment of Narrative Review Articles (SANRA). Fatal environmental hyperthermia is usually an exclusionary diagnosis because gross and microscopic findings are nonspecific and may be modified by cooling, survival interval, postmortem interval and decomposition. No biochemical, immunohistochemical, proteomic, or lipidomic marker independently confirms the diagnosis. Heat may be the principal cause of death, a material contributor acting through natural disease, or a population-attributable exposure that cannot be assigned confidently to an individual decedent. Certification practices vary across jurisdictions, and matched event comparisons show that modelled excess mortality can exceed individually attributed deaths without making the two measures interchangeable. Forensic and epidemiological counts should be reported as complementary measures. Standardized scene data, case-appropriate toxicology, explicit certification of contributory heat exposure, linkage of medicolegal and vital-statistics records, and joint interpretation with excess-mortality models would improve surveillance and prevention.
As populations worldwide continue to grow older, an increase in cases involving aged individuals is also to be expected in medico-legal autopsies. The aim of this study was to report the neuropathological diagnoses of individuals aged >= 65 years, and to compare the findings across three age groups: youngest-olds (65-74 years of age), middle-olds (75-84) and oldest-olds (>= 85). The sample comprised all Finnish medico-legal autopsies of individuals aged >= 65 years whose autopsy included a full neuropathological examination performed by a neuropathologist over the period 2016-2022 (n = 629). Neuropathological diagnoses were obtained from the neuropathologists' reports, and background characteristics were collected from medico-legal cause-of-death investigation documents. Of all cases, 97.1% received at least one neuropathological diagnosis. The prevalences of many neurodegenerative diseases increased with age; Alzheimer's disease neuropathological change (30.5%) and cerebral amyloid angiopathy (14.0%) were the most common ones. However, some rarer neurodegenerative diseases were more frequent among youngest-olds. While the prevalence of acute infarcts remained relatively consistent across the age groups (12.4-14.5%), old infarcts and subarachnoid haemorrhages were most common among oldest-olds (22.1% and 16.6%, respectively). The age-related increase in subarachnoid haemorrhage diagnoses appeared to be primarily driven by the male sex. The prevalences of acute and old traumatic brain injuries were rather low (5.7-6.2% and 5.1%, respectively) and remained relatively stable across the age groups. In conclusion, our data suggest that neuropathological diagnoses are highly prevalent among aged individuals undergoing medico-legal autopsy, and many diagnoses become more frequent towards oldest-olds.
Digital pathology has transformed anatomic pathology by enabling whole-slide imaging, remote review, reproducible annotation, image analysis, and the development of artificial intelligence-based decision-support tools. In forensic pathology, however, the transition from glass slides to digital forensic histopathology remains in its early stages, despite recent evidence supporting the feasibility and diagnostic reliability of whole-slide imaging in medico-legal practice. The subsequent crucial step involves not merely digitizing forensic slides but also developing curated, multicentric, legally governed, and controlled-access datasets comprising forensic histopathological images. Such datasets are essential for education, interobserver harmonization, external quality assessment, and the development of reproducible quantitative tools suitable for forensic applications. This perspective paper argues that forensic pathology should regard datasets as scientific infrastructure rather than as passive image collections. An artificial intelligence-ready forensic histopathology dataset should include whole-slide images, standardized annotations, technical acquisition parameters, histological processing information, forensic metadata, quality-control records, reference standards, uncertainty labels, and explicit governance rules. Although important lessons can be drawn from anatomic pathology datasets, forensic pathology presents specific challenges, including low case numbers, post-mortem artifacts, heterogeneous sampling, variable fixation and preservation conditions, judicial and privacy concerns, and differences in national regulation of post-mortem data. We therefore propose a literature-informed conceptual framework for the development of forensic histopathology datasets, intended for forensic pathologists, researchers, institutional stakeholders, and AI tools developers. The framework is intended to support the development of shared resources for education, research, and AI development and validation, thereby providing a foundation for trustworthy and scientifically defensible computational applications in forensic pathology.
Areas of pigmented skin exposed to sunlight after death may appear darkened, a change known as postmortem tanning. It may be mistaken for livor mortis, for postmortem drying, or for a tan acquired during life, and it remains little recognized in forensic pathology, although six cases have been reported since 2023. Scopus and PubMed were searched to August 2026 using the terms “postmortem pigmentation”, “immediate pigment darkening”, “persistent pigment darkening”, and “delayed tanning”. Reports of darkening of pigmented human skin by ultraviolet radiation or heat, in living, excised or cadaveric tissue, were included; studies confined to delayed tanning, melanoma or non-human pigment were excluded. Historical German-language works were retrieved by citation chaining. Two cases of our own are described. Postmortem tanning is closely related to immediate and to persistent pigment darkening in living skin, and to the Meirowsky and Lignac darkening of excised and cadaveric skin. All involve modification of melanin already present rather than new synthesis, so that darkening need not indicate an increase in the quantity of melanin; this has recently been demonstrated chemically in human skin without circulation. Recognition rests on a sharply demarcated area of darker skin following the margins of clothing and the geometry of sun exposure. The principal differential diagnoses are livor mortis, postmortem drying, and an antemortem tan; immediate and persistent pigment darkening arising shortly before death cannot be distinguished from it morphologically. In our two cases, the microscopic difference was slight or absent, as the current chemistry would predict. The boundary between darkened and adjacent non-darkened skin should be photographed and marked in the fresh state because fixation may obliterate it. Paired samples should be preserved for chemical analysis, which remains the decisive test. Why eumelanin is black remains unsettled. Postmortem tanning is related to two forms of tanning in living skin unfamiliar to forensic pathologists: immediate pigment darkening (IPD) and persistent pigment darkening (PPD). The triad theory of Miescher and Minder (1939), which unified IPD and PPD with the Meirowsky and Lignac phenomena, provides a framework for understanding postmortem tanning. Modification of pre-existing melanin, rather than de novo synthesis alone, is the more likely principal mechanism; visible darkening need not indicate any increase in the quantity of melanin. The principal differential diagnoses are livor mortis, postmortem drying and a tan acquired during life; they are separated chiefly by distribution. Pigment darkening produced by UVA shortly before death carries no vital reaction and is morphologically identical to postmortem tanning; the distinction rests on case circumstances, not on the skin. The boundary should be marked before fixation, and unstained sections considered alongside stained preparations, although histology alone cannot establish the diagnosis.
