Forensic Pathology for Police - Brainshare Public Online Library

482 19 Burns and Fire-Related Deaths
Besides thermal injury, burns can result from contact with chemical substances
or as a result of exposure to various forms of radiation. In each of these situations,
a thermal component may play a role in tissue damage, but other mechanisms are
also present.
Burn severity as seen on the skin surface may be categorized as follows. First
degree burns demonstrate a red discoloration of the skin surface. Physicians may
frequently describe this as “erythema.” Such burns are limited to the epidermis
(Fig. 19.1). Second degree burns damage not only the epidermis, but also the upper
dermis. These burns are characterized by blisters and skin “slippage” (Fig. 19.2).
In third degree burns, full-thickness skin injury occurs (Fig. 19.3). Fourth degree
burns are characterized by charring of the skin and underlying subcutaneous tissues
(Fig. 19.4). If one considers the skin as an organ, it represents the largest organ
Fig. 19.1 The intact, dark-appearing skin (centrally) represents a first degree burn. The adjacent
burns with skin slippage are second degree burns
Fig. 19.2 Example of second degree burns seen at autopsy. Note the slippage of skin