Gross and histologic postmortem changes of the skin

Many methods have been attempted to accurately and systematically determine the estimated time of death in autopsy cases. Gross changes of the skin which occur during the postmortem interval have occasionally been used to estimate the time of death under different conditions; however, the postmortem gross and histologic changes of the skin have not been systematically analyzed. We sequentially studied the gross and microscopic appearance of skin in 3 individuals during the early postmortem interval (<1 week) in an outdoor, shaded, cool to temperate climate. Photos and skin biopsy specimens were taken from 4 sites (acral skin, scalp, dependent truncal skin, and nondependent truncal skin) every 12-24 hours on each individual. The gross appearance of the skin remarkably did not change significantly in any of the sites after 1 week of decomposition. Three main histologic changes were seen in the skin biopsy specimens: focal dermal-epidermal separation, eccrine duct necrosis, and dermal degeneration. Although bullae were not present in the gross examination of the skin, focal separation of the epidermis from the dermis was appreciated in several skin biopsies; however, the timing of development was unpredictable. Eccrine duct necrosis was another histologic finding and was relatively predictable, occurring in dependent and nondependent truncal skin biopsies from all 3 individuals between days 4 and 7. Dermal degeneration was a uniform histologic finding only in biopsies from nondependent truncal skin, occurring in all individuals on day 2. Although this study is limited by the small number of subjects and uncontrolled extrinsic factors, histologic findings, such as eccrine gland necrosis and dermal degeneration, in select cutaneous biopsies may be useful in estimating the time of death in the early postmortem interval.