Diagnostic pitfalls in forensic pathology: Postmortem facial lesions mimicking trauma caused by pharaoh ants...

Misinterpretation of insect-related postmortem artifacts as traumatic injuries remains a critical diagnostic challenge in forensic pathology, particularly in enclosed indoor environments. We report a case involving a deceased adult male found indoors with multiple superficial perioral and facial lesions initially suspected to be perimortem trauma. However, based on photographic evaluation by a forensic entomologist, the lesions were identified as likely caused by postmortem activity of Monomorium pharaonis (pharaoh ants), a synanthropic species commonly found in human dwellings. Numerous ant eggs and larvae were subsequently discovered in the folds of the decedent's clothing, and the lesion morphology was consistent with postmortem necrophagy rather than true antemortem injury. This case represents the first formally documented instance in South Korea in which pharaoh ant-induced artifacts led to the avoidance of an erroneous forensic interpretation of violence. The findings highlight the importance of considering insect activity in the differential diagnosis of soft tissue lesions and demonstrate how inconspicuous insect activity can mimic violence-related injuries. Integration of entomological expertise-particularly early in scene evaluation-is essential to prevent unnecessary autopsies and medicolegal errors.