Sir,

Forensic dermatology refers to the examination of the skin, hair and nails to determine a specific cause or mechanism of whichever injury.

This can provide important insight into the medicolegal autopsy, particularly in cases where the death is violent, unexplained, suspicious, or unexpected.

The dermatologist may also encounter classic presentations of abuse, neglect, or torture, in clinical practice [1,2].

In this paper the AA wanted to demonstrate that a simplest medieval recipe made of chestnut fruit julep and Portulaca oleracea oil is sufficient to reveal if in case of serious oedematous carreaux of the injured genital area, thare has been a situation of violence or a compliance by the “victim”.

The forensic examination following rape has two primary purposes: to provide health care and to collect evidence. Physical injuries need treatment so that they heal without adverse consequences. The pattern of injuries also has a forensic significance in that injuries are linked to the outcome of legal proceedings.

Genital injury prevalence, which is calculated from injury frequency, can be described as the proportion of females with an occurrence of any injury at an anogenital location following sexual assault. Anogenital injury location can be classified as external (labia majora, labia minora, periurethral area, perineum, and posterior fourchette), internal (fossa navicularis, hymen, vagina, cervix), and anal (anus and rectum).

The prevalence of genital injury resulting from sexual assault varies by examination type and ranges from 5% on direct visualization to 87% with colposcopic technique.

Three primary strategies exist for genital examination: (a) direct visualization with the unaided eye; (b) staining techniques (Gentian violet, Lugol’s solution, toluidine blue, fluorescein, or a combination of these staining techniques), which are applied topically to highlight injuries and make them more visible to the eye; and (c) colposcopy (use of a magnifying instrument [colposcope] with a light source and digital imaging and/or photographic capability).

Colposcopy is a diagnostic procedure that allows your provider to check your cervix (lower part of uterus) and the wall of the vagina for abnormal tissue. During the procedure, a special lighted microscope called a colposcope magnifies the tissue that lines the cervix and vagina.

Sexual violence generally includes: • forcing woman to have sex or perform sexual acts when she doesn’t want to • harming her during sex • forcing her to have sex without protection from pregnancy or infection. Identifying a woman who may subjected to violence:

It is important for health-care providers to be aware that a woman’s health problems may be caused or made worse by violence. She may be facing ongoing abuse at home or has in the past. Or she may have suffered a sexual assault recently or in the past. Women subjected to violence in relationships often seek health care for related emotional or physical conditions, including 9 injuries. However, often they do not tell you about the violence due to shame or fear of being judged or fear of their partner. You may suspect that a woman has been subjected to violence if she has any of the following: • ongoing emotional health issues, such as stress, anxiety or depression • harmful behaviours such as misuse of alcohol or drug • thoughts, plans or acts of self-harm or (attempted) suicide • injuries that are repeated or not well explained • repeated sexually transmitted infections • unwanted pregnancies • unexplained chronic pain or conditions (pelvic pain or sexual problems, gastrointestinal problems, kidney or bladder infections, headaches) • repeated health consultations with no clear diagnosis.

In a fortunate occasion of a Medieval Festival in a hamlet close to Rome (the Sagra della Castagna, Chestnut Feast) comprehensive of a series of duels by jugglers in medieval costumes and consequent guidedons, the AA noticed a lot of kiosks selling a special ointment made of chestnut pulp julep and Portulaca oleracea oil (Porcacchia is a typical plant native to Tuscia, the region close to Rome and Tuscany, but this infesting plant that in these lands is commonly named Porcacchia, is widespread throughout the entire word, eg:

Portulaca is a genus of flowering plants in the family Portulacaceae, and is the type genus of the family [3,4]. With over 100 species, it is found in the tropics and warm temperate regions. Portulacas are also known as the purslanes.

Common purslane (Portulaca oleracea) is widely consumed as an edible plant, and in some areas it is invasive. Portulaca grandiflora is a well-known ornamental garden plant. Purslanes are relished by chickens. Some Portulaca species are used as food plants by the larvae of some Lepidoptera species including the nutmeg moth (Hadula trifolii).

Portulaca oleracea (middle right)Pickled purslane stems consumed in Armenia.

Most of the following species are accepted:

Portulaca africana (Danin & H.G.Baker) Danin – Western Africa to south China; Portulaca almeviae Ocampo – Mexico; Portulaca amilis Speg. – Paraguayan purslane – Peru to Brazil and N. Argentina; Portulaca anceps A.Rich. – Ethiopia; Portulaca argentinensis Speg. – Argentina; Portulaca aurantiaca Proctor – Jamaica; Portulaca australis Endl. – N. & NE. Australia to W. Central Pacific; Portulaca badamica S.R.Yadav & Dalavi – India; Portulaca bicolor F.Muell. – Australian pigweed – Australia; Portulaca biloba Urb. – Cuban purslane – Cuba; Portulaca brevifolia Urb. – Cuba to Haiti, NW. Venezuela; Portulaca bulbifera M.G.Gilbert – Ethiopia, Kenya; Portulaca californica D.Legrand – Mexico; Portulaca canariensis Danin & Reyes-Bet. – Canary Islands; Portulaca rausii Danin – Mediterranean; Portulaca sardoa Danin, Bagella & Marrosu – Corsica, Sardinia; Portulaca sicula Danin, Domina & Raimondo – Sicilia; Portulaca zaffranii Danin – Mediterranean.

It is possible to notice that Mediterranean Basini s a good enclave to produce spontaneous Porchiacca in every season of the year (October is the best period for harvesting or extirpating it).

As far as Castanea sativa is concerned there is a newest fashion since last years of XX century that predicts the usage of the shell extract as rejuvenating and repairing senescent skin in cosmetics but in the kiosks of the Festival of Chestnut it was possible to purchase jars of Castanea sativa pulp of fruit julep mixed with Porchiacca lypophilic extract (Portaluca oleracea oil).

Porchiacca is richest in Portulacanones A,B,C and D, excellent to reduce oedemas and in wound-healing of delicate skin of virgin or younger women of whichever type and Castanea sativa is welknown from ancestral times to repair injured derm and skin wound healing, really since Middle Age (as linum usitatissimum seed oil) [5].

It has been sufficient for the AA to recognize the real efficacy of this ointment: they have had the chance to encounter a girl (23 y. old) who had a violent intercourse (albeit she was fully condescent and compliant with the young boy) and her inner and outer labia and inner groin were swollen, sore and aching.

Owing to a physician, friend and colleague of the AA, it has been possible to examinate the vagina and the lower part of the uterus of the “victim” with the aids of a colposcope, after having spread the ointment purchased at the Medieval Festival, for 2 days, 3 times/day.

So, the experiment has demonstrated that there has not been sexual violence in this case, as after three days the derm and hypodermis colcoscopy images were perfect at all.

Effectively, the colposcope images demonstrated a normal diorama showing the ectocervix pale pink, shiny, round surface, which is covered with squamous epithelium. At the center of the ectocervix the external cervical os, an opening that continues as the endocervix (also called the cervical canal), is lined with glandular epithelium, meanwhile three days before the final and decisive evaluation the colposcope images were characterised by:

Thickness of the epithelium – a result of the number of cells and their maturation. Variations in blood vessel patterns. Alterations in surface contour and any associated changes in the covering epithelium (keratinization). Preliminary proofs with Acetowhite indicated that cervical epithelium appeared grossly normal but it turned white after the application of acetic acid solution (3-5%).

REFERENCES

1. Sommers MS. Defining patterns of genital injury from sexual assault. Trauma Violence Abuse. 2007;8:270–80.

2. Anderson S, McClain N, Riviello RJ. Genital findings of women after consensual and nonconsensual intercourse. J Forensic Nurs. 2006;2:59–65.

3. Crane PA. Predictors of injury associated with rape. J Forensic Nurs. 2006;2:75–83.

4. Tleubayeva MI, Datkhayev UM, Alimzhanova M, Ishmuratova MY, Korotetskaya NV, Abdullabekova RM, et al. Component composition and antimicrobial activity of co2 extract of portulaca oleracea, growing in the territory of Kazakhstan. ScientificWorldJournal. 2021;2021:5434525.

5. Yan J, Sun LR, Zhou ZY, Chen Y-C, Zhang W-M, Daiet H-F, et al. Homoisoflavonoids from the medicinal plant Portulaca oleracea. Phytochemistry. 2012;80:37-41.