MORPHO-HISTOLOGICAL CHARACTERISTICS OF BRUISES WITH DIFFERENT AGE - QUALITATIVE STUDY

  • Irena Kostadinova Petrova Institute of Medical Histology and Embryology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Elida Mitevska Institute for histology and Embryology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, Republic of North Macedonia,
  • Lena Kakasheva Mazhenkoska Institute for histology and Embryology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, Republic of North Macedonia,
  • Ljubica Tasheva Institute for histology and Embryology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, Republic of North Macedonia,
  • Natasha Stojkovska Institute for histology and Embryology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, Republic of North Macedonia,
  • Biljana Janeska Institute of Forensic Medicine and Criminology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, Republic of North Macedonia

Abstract

Bruises are common skin lesions that occur as the force hits the skin, but integrity of the skin is not impaired. Their significance is important in forensic expert reports in determining the time of death in many cases of domestic violence or child abuse. The aim of this study was to present the differences between bruises with different time of origin by evaluation of their morpho-histological characteristics.  The study included 60 human skin samples divided into control and experimental groups A, B, C, D. The experimental group A included bruised human skin samples with <1day old bruises, experimental group B included bruised human skin samples with 1-3 days old bruises, experimental group C included bruised human skin samples with 3-7 days old bruises and experimental group D included bruised human skin samples with 7-14 days old bruises. Paraffin sections of the skin were stained with Hematoxylin-eosin, Giemsa, Perl’s Prussian Blue, Masson-Goldner methods of staining and application of anti-HO-1 antibody. All paraffin sections were evaluated by light microscopy and photodocumented. Our results have shown changes in color in bruises with different age due to infiltration with different immune cells and metabolism of extracellular hemoglobin.  Granulocyte infiltration is seen shortly after the initiation of the bruise, while after few days of initiation, usually 1-3, there is macrophage infiltration in the field of bleeding. Presence of macrophages in the field of bleeding increases as bruises age. These histological characteristics appear in direction of healing the bruise, together with phagocytosis of the erythrocytes and removing the tissue debris. 


Keywords: bruises, time of origin, morpho-histological characteristics, microscopic analysis 

References

1.Senn DR, Weems RA. Manual of Forensic Odontology, Fifth Edition. CRC Press, 2013. ISBN  9781439851340.
2.Dogra Dr.TD.Lyons: Medical Jurisprudence & Toxicology, 11th ed. New Delhi: Delhi Law House; 2015
3.Robinson S. The examination of the aduld victim of assult. In: Mason JK, Purdue BN, editors. The pathology of trauma. London: Arnold; 2000. p. 144-148.
4.Hiss J, Kahana T. Medicolegal investigation of death in custody: a postmortem procedure for detection of blunt force injuries. Am J Forensic Med Pathol 1996;17:312-314.
5.Hiss J, Kahana T, Kugel C. Beaten to death: why do they die? J Trauma 1996;40:27- 30.
6.Oenmichen M. Vitality and time course of wounds. Forensic Sci Int 2004;144:221-231
7.Ortonne JP. Normal and abnormal skin color. Ann Dermatol Venereol 2012;139 Suppl 4:S125-9.
8.Bonhert M, Baumgartner R, Pollak S. Spectrophotometric evaluation of the color of intra- and subcutaneous bruises. Int J Legal Med 2000;113:343-348.
9.Kienle A, Lilge L, Vitkin A, Patterson MS, Wilson BC, Hibst R, Steiner R. Why do veins appear blue? A new look at an old question. Appl Optics 1996;35:1151-1160.
10.Kollias N. The physical basis of skin color and its evaluation. Clin Dermatol 1995;13:361-367.
11.Randeberg LL, Winnem A, Blindheim S, Haugen OA, Svaasand LO. Optical classification of bruises. Proc SPIE 2004;5312:54-64.
12.Trujillo O, Vanezis P, Cermignani M. Photometric assessment of skin color and lightness using a tristimulus colorimeter: reliability of inter and intra-investigator observatios in healthy adult volunteers. Forensic Sci Int 1996;81:1-10.
13.Stephenson T. Ageing of bruising in children. J R Soc Med 1997;90:312-314.
14.Zahidul Alam Md , Devalaraja S , Haldar M. The Heme Connection: Linking Erythrocytes and Macrophage Biology. Front Immunol. 2017 Jan 24;8:33.
15.Takamiya M, Saigusa K, Kumagai R, Nakayashiki N, Yasuhiro A. Studies on mRNA expression of tissue type plasminogen activator in bruises for wound age estimation. Int J Legal Med 2005;119:16-21.
16.Garner WL, Rodrigues JL, Miller CG, Till GO, Rees RS, Smith DJ, Remick DG. Acute skin injury releases neutrophil haemoattractants. Surgery 1995;116:42-8.
17.Harris BH, Gelfand JA. The immune response to trauma. Semin Pediatr Surg 1995;4:77-82.
18.Baranano DE , Rao M, Ferris CD, H Snyder SH. Biliverdin reductase: a major physiologic cytoprotectant. Proc Natl Acad Sci U S A. 2002 Dec 10;99(25):16093-8.
19.Otterbein LE, Choi AMK. Heme oxygenase: colors of defense against cellular stress. Am J Physiol Lung Cell Mol Physiol 2000;279:L1029-L1037.
20.Sugishima M, Wada K, Fukuyama K. Recent Advances in the Understanding of the Reaction Chemistries of the Heme Catabolizing Enzymes HO and BVR Based on High Resolution Protein Structures. Curr Med Chem. 2020;27(21):3499-3518.
21.Fullerton A, Fischer T, Lahti A, Wlhelm K-P, Takiwaki H, Serup J. Guidelines for measurement of skin color and erythema: a report from the Standardization Group of the European Society of Contact Dermatitis 1996;35:1-10.
22.Wiglesworth A , Austin R, Corona M, Schneider D, Liao S, Gibbs L, Mosqueda L. Bruising as a marker of physical elder abuse. J Am Geriatr Soc 2009;57(7):1191-6.
23.Gerstein AD, Phillips TJ, Rogers GS, Gilchrest BA. Wound healing and aging. Dermatol Clin 1993;11:749-757.
24.Ashcroft GS, Mills SJ, Ashworth JJ. Aging and wound healing. Biogerontology 2002;3:337-345.
Published
2022-08-31
How to Cite
KOSTADINOVA PETROVA, Irena et al. MORPHO-HISTOLOGICAL CHARACTERISTICS OF BRUISES WITH DIFFERENT AGE - QUALITATIVE STUDY. Journal of Morphological Sciences, [S.l.], v. 5, n. 2, p. 56-67, aug. 2022. ISSN 2545-4706. Available at: <http://www.jms.mk/jms/article/view/vol5no2-10>. Date accessed: 28 mar. 2024.
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Articles