Histological Alterations in Human Skin as a Function of Postmortem Interval

The determination of time since death (TSD) is one of the important objectives of a forensic autopsy. This narrative review aims to analyze the current literature on histological markers of human skin used to estimate the TSD and to assess their reliability and limitations in determining the postmortem interval. A total of five studies were reviewed based on the inclusion criteria. The key histological markers proposed by researchers include dermo-epidermal separation, vacuolation at the cellular level in the skin and its appendages, and progressive dermo-epidermal degeneration. The staining techniques commonly used by researchers are hematoxylin and eosin and Alcian- Periodic Acid Schiff stain (PAS). With the degradation of glycogen occurring within the first few hours postmortem, the cells begin to stain PAS-negative. Most of the studies had small sample sizes and did not account for confounding factors such as age, sex, and cause of death. Inconsistencies in methodology and the subjective nature of interpretation limit their generalizability. Future research should aim for larger sample sizes and be conducted across different seasons to account for environmental variations. Where feasible, studies incorporating both histometrics and histomorphological alterations in skin should be considered.