A lightning strike victim is found dead. Which of the following features is PATHOGNOMONIC of lightning strike and not seen in other electrical fatalities?

• A Entry and exit burns at hands and feet
• B Haemorrhage into the tympanic membrane from blast effect
• C Cardiac arrhythmia and respiratory arrest
• D Lichtenberg figures (arborescent/ferning marks) on the skin ✓

Explanation

Lichtenberg figures (also called fern-like burns, keraunographic marks, or lightning flowers) are skin surface markings appearing as reddish-brown arborescent branching patterns, resembling a fern or tree, produced by the flash-over effect of lightning current along the skin surface rather than through deep tissues. They typically appear within hours and fade over days. They are seen only in lightning strike victims and are pathognomonic of lightning, not domestic electrical injuries. They are not true burns but result from extravasation of blood vessels under the current's electromagnetic path.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.