Electric death: forensic pathological analysis and candidate biomarkers for forensic diagnosis

Electrical injury is a severe multisystem trauma that is characterized by high clinical risk and mortality. For forensic practitioners, the diagnosis of electrocution death depends primarily on typical electric marks, scene investigations, and medical case information, which essentially constitute an exclusionary diagnostic procedure. Establishing a reliable diagnostic method for electrocution death, particularly in cases without visible electric marks, remains an urgent challenge in routine forensic practice. We retrospectively analyzed forensic electrocution death cases to screen novel molecular biomarkers for the diagnosis of mark‑absent electrocution death. Focusing on electric shock-induced malignant arrhythmia and cutaneous metal deposition, we detected the expression of oxidative stress‑sensitive genes in myocardial tissue and Cu²⁺‑dependent cuproptosis‑related genes in palmar skin. The Cu²⁺ concentration in palmar skin, combined with the expression levels of skin genes (e.g., FDX1 and CXCL6) and myocardial genes (e.g., GCLM and PRDX4), may serve as potential biomarkers for the auxiliary diagnosis of mark‑absent electrocution death. The combined detection of skin and myocardial samples provides a valuable auxiliary diagnostic strategy for challenging forensic cases.