10 A practical guide to the Istanbul Protocol – for medical doctors scars had disappeared. The remaining scars were small, white or red-brown spots. ≠≠ Among the skin diseases leaving pigmented scars is lichen planus leaving about 2 mm large scars. ≠≠ Electrical torture has been reported to induce 6-8 mm large, irregular, red-brown, keloid scars on the helix of both ears (Bork & Nagel, 1997). ≠≠ Differential diagnosis might be a chondrodermatitis helicis, but this is usually covered by a scale, and is pale and painful. Six months after the use of a 45 cm long stun gun, delivering 150,000 V, with a screw 4 mm in diameter at its end and 12 small places from which electricity is also emitted from the lower part of its side, a sharply demarcated bluish line 1 mm across, forming a complete circle 5 mm in diameter and a second mark of similar characteristics completing only two-thirds of a circle, were observed (European Committee for the Prevention of Torture, 1998). ≠≠ Similar fractions of a narrow red ring appearing in segments have been seen in the days after defibrillation using 2736 V along the periphery of the pad (Danielsen et al., 2003). They have been found to be due to a high current density under the perimeter of the electrodes. 7. SKIN DISEASES An example of a skin disease being psychologically provoked by torture may be the concomitant occurrence of an urticarial eruption. Physically provoked skin diseases may be the development of psoriasis or lichen planus in the traumatised area, as a “Koebner reaction” (Danielsen, 1992). However, such skin changes have little diagnostic significance in relation to torture.