'Lichtenberg figure' as a result of lightning shock.

Correspondence to: Mehmet Ergin, Department Emergency, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey Phone: +90 532 345 26 73 e-mail: [email protected] ©Copyright 2014 by the Atatürk University School of Medicine Available online at www.eajm.org DOI:10.5152/eajm.2014.37 This study was presented at 7th European Congress of Emergency Medicine (EuSEM 2012), 3-6 October 2012, Antalya, Turkey. Received: February 15, 2013 / Accepted: May 07, 2013 / Available Online Date: July 8, 2014 A 30 year-old-male was found unconscious while working outdoors. After completion of the initial evaluation, the Primary Health Care Center referred him to our emergency department. He couldn’t remember what had happened to him and he was complaining of chest and back pain. His vital signs were in the normal ranges, and his physical examination values were normal except for the skin findings (Figure 1). The findings in his ECG, complete blood count, other laboratory results and braincomputed tomography were in the normal ranges. Mainly six types of cutaneous findings occur as a result of being struck by lightning. They include linear burns, punctate burns, Lichtenberg figures (LF), contact burns from overlying metal objects, superficial erythema and their combinations [1]. Moreover, entry and outlet holes of lightning strikes are rarely seen [2]. The painless, hyperemic, spreading and ferning patern figure on the skin is called Lichtenberg figure (LF). It matches no anatomical, vascular, or neural patterns. Contrary to thermal and electrical burns, it is harmless to epidermis and deeper tissues. Although the exact mechanism is unknown, it is thought that they represent red blood cells extravasated into the superficial layers of the skin from capillaries secondary to the dielectric breakdown of the skin and subsequent massive electron shower [2]. Our patient was admitted to the observation unit. The patient, who was on observation status for 48 hours, discharged from the hospital and recommended to attend the outpatient clinic. If a victim found unconscious outdoors, strike of lightning should be considered in the differential diagnosis. Pathognomonic skin findings should not be overlooked.