PART A – Dermatological findings after alleged torture Two parallel linear lesions (“tramline bruises”) result from a blow with a rod or stick (Knight, 1991a). The haemorrhagic areas often move down the body during the following days. Deep tissue bruises might not be seen on the surface. The lesions change colour from dark red, to dusky purple, to brown, to green, to yellow and to hyperpigmented brown, or they disappear. Severe beating on the soles of the feet, “Falanga”, may leave contusions in the arch of the feet and swelling of the feet extending from the arch to the medial aspects of the feet and ankles (Bro-Rasmussen & Rasmussen, 1978). Blunt trauma often leaves no or uncharacteristic scars (Cohn et al., 1978). Flogging or beating with canes or truncheons may, however, leave characteristic scars, e.g. asymmetric, linear, straight or curved or “tramline”-shaped scars, showing a pattern of external infliction (Danielsen, 1992; Petersen & Rasmussen, 1992; Forrest 1999). The scars may be hypertrophic with a narrow, regular, hyperpigmented area in the periphery, representing “arrowline” bruises or an inflammatory zone appearing around necrotic tissue in the acute phase (Fig. 1) (Danielsen, 1992). ≠≠ A differential diagnosis could be plant dermatitis, usually dominated, however, by shorter scars, with a narrow zone of hyperpigmentation in the periphery. In one case, the alleged torture was beating and scalding on the back. Symmetrical, atrophic, depigmented, linear changes typical for striae distensae were observed on the back and in both axillary regions (Fig. 2) (Danielsen, 1992). The skin changes could not support the history of torture. The patient, however, may have been unaware of the changes on the back before the torture. Prolonged application of tight ligatures may leave a linear zone extending circularly 7 around the arm or leg, in one case with lack of hair indicating cicatricial alopecia (Danielsen & Berger, 1981). ≠≠ No differential diagnosis in the form of a spontaneous skin disease exists because of the location of the scar. 3. SHARP TRAUMA Sharp trauma, e.g. caused by the use of a razor blade, knife or bayonet, gives characteristic ulcers and usually leaves recognisable scars. In some cases, self-infliction should be considered, particularly when located on a wrist (Danielsen, 1992, Petersen & Rasmussen, 1992). If pepper is applied to the open wounds, the scars may become hypertrophic (Danielsen, 1992). ≠≠ A differential diagnosis could be traditional healers, African ritual scar-tattoos or art on the body (Nancke-Krogh, 1985). In one case, where the deepness of a scar, allegedly following the use of a sword, was doubted, the use of a high-frequency ultrasound could demonstrate a considerable, deep scar (Gniadecka & Danielsen, 1995). Afterwards, the patient was granted refugee status. 4. THERMAL INJURIES Burning with cigarettes, hot instruments or hot fluids leaves acute burns of varying degrees. Burning is the form of torture that most frequently leaves scars, often of diagnostic value. Cigarette burns often leave 5-10 mm large, circular and macular scars with a depigmented centre and a hyperpigmented, rela-