In a case of death due to electrocution at household voltage (220V AC), postmortem examination shows a small, pale, firm, raised lesion with a central pale area surrounded by a ring of hyperpigmentation at the entry site on the right hand. This finding is BEST described as:

• A Electrical entry wound (Electromark / Fiessinger's sign) ✓
• B Joule burn (electrothermal mark / Lichenberg figure)
• C Contact burn from radiant heat
• D Arc flash burn

Explanation

At the entry site of domestic current, the electromark (also called a Joule burn or electrical mark) appears as a pale, crater-like lesion with a central depressed/pale zone surrounded by a palisaded rim of hyperpigmented, raised epithelium—often likened to a 'volcano crater.' This is produced by resistive heating at the point of current entry. Lichtenberg figures are fern-like superficial skin burns seen in lightning injuries (high-voltage DC). Arc flash burns are external flame/spark burns from an electrical arc without direct current passage through the body.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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Written and medically reviewed by the StethoPrep medical team.