skin to be noted are cleanliness, elasticity, general nutrition,
moisture, presence of scales, atrophy, hyperplasia (ichthyosis,
horny warts, cutaneous horns, the various forms of elephantiasis),
scleroderma, keloid, xeroderma pigmentosum, albinism, leucoderma,
vitiligo, myxœdema, seborrhœa, alopecia, erysipelas, dermatomyositis,
psoriasis, impetigo, rhinophyma, herpes, miliaria, sudamina,
symmetrical gangrene, trophic changes, “goose-flesh,” hemorrhages,
scars, tattoo-marks, etc. The various forms of skin-diseases should
be described and recorded whenever present.
The presence of petechiæ or ecchymoses in the skin (purpura) is
characteristic of all the forms of essential purpura (simplex,
peliosis rheumatica, hæmorrhagica, senilis, morbus maculosis
Werlhofii, scurvy, Möller-Barlow disease, etc.); such skin
hemorrhages occur also as the result of trauma, congenital
hæmophilia, in the course of many infections (small-pox, plague,
typhus, yellow fever, endocarditis, measles, scarlet fever,
septicæmia, pyæmia, rheumatism, meningitis, typhoid fever), in many
intoxications (snake-bite, icterus, nephritis, iodine, bromine,
phosphorus, chloroform, etc.), also in severe anæmia, pernicious
anæmia, leukæmia, sarcoma, carcinoma, acute yellow atrophy of
the liver, hysteria, vicarious menstruation, reflex hemorrhages,
stigmatization, etc. The number, size, color and location of all
cutaneous hemorrhages should be recorded.
24. =Hair.= Color, abundance, distribution, character, quality,
condition, length, pathologic conditions (alopecia areati, senilis,
præsenilis, pityrodes, syphilitica and symptomatica, trichorrhexis
nodosa, hypertrichosis, parasites, etc.). In prolonged fevers and
wasting diseases the diameter of the hair is diminished. Symptomatic
alopecia occurs after syphilis, typhoid fever, scarlet fever,
measles, erysipelas, anæmia, Roentgen irradiation, etc. The length,
color and quality of the hair as well as amount and distribution
vary in different races. Hypertrichosis is often associated with
degeneracy, criminal tendency, epilepsy, idiocy and certain forms
of insanity. An apparent growth of hair after death may be caused
by retraction of the tissues; an actual postmortem growth is not
conceded by the majority of authorities in spite of the numerous
tales to that effect. Loss or absence of pigment is seen in albinism,
leukotrichia due to infection, Graves’ disease, exposure, burns,
nervous affections, fright, worry, etc. The presence on or about
the body of hairs not belonging to the cadaver is a point of great
importance in medicolegal cases and one that should be thoroughly
investigated as to their source. Human hair can be identified
microscopically, and it is possible to recognize different specimens
according to their variation in color, length, quality, etc.
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