Foot Torture (Falanga): Ten Victims with Chronic Plantar Hyperpigmentation

Falanga is a widespread form of torture, but details of the chronic skin sequelae on physical examination are unreported.

In an organization dedicated to the care of torture victims, we prospectively documented examination findings in 10 consecutive, black African falanga victims.

Ten individuals (8 men) suffered 1 or more episodes of falanga, most recently 9 to 29 months (9 cases) or 10 years (1 case) earlier. Examination revealed 3 to 50 or more pigmented macules, most greater than or equal to 0.5 cm in size, on both soles of all 10 victims. The degree of pigmentation and border distinctness of the lesions varied. Two cases had plantar tenderness.

Plantar hyperpigmentation was present in all cases 9 months to 10 years after suffering falanga. This physical sign can support victims' legal requests for political asylum, and its recognition can aid physicians who care for torture victims.