Forensic Science International 282 (2018) 74–78

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Forensic Science International

journal homepage: www.elsevier.com/locate/forsciint

Visualization of old bruises in children: Use of violet light to record

long-term bruises
Sohtaro Mimasaka* , Toru Oshima, Maki Ohtani
Department of Forensic Sciences, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita 010-8543, Japan

A R T I C L E I N F O A B S T R A C T

Article history:
Received 19 August 2017 When a child consultation center evaluates abused children, evidence of the abuse must be documented.
Received in revised form 18 October 2017 Children who have suffered physical abuse often have bruises, which cannot be confirmed by
Accepted 8 November 2017 visualization when the bruise has healed. In forensics, a method to confirm an old bruise by ultraviolet
Available online 16 November 2017 radiation is possible. However, long-term ultraviolet exposure can be harmful. In this study, we observed
15 bruises on healthy volunteer children using four kinds of light sources, including ultraviolet radiation,
Keywords: over time. The violet light source enabled observation of a bruise for a longer time than ultraviolet
Bruise radiation. Although other studies have shown that violet light is superior for enhancing bruises, this is the
Child abuse
first report to evaluate data concerning the ability to identify bruises over time in living children. These
Forensic science
results might help to identify evidence of past violence suffered by children.
Ultraviolet radiation
Forensic light sources © 2017 Elsevier B.V. All rights reserved.

1. Introduction Therefore, although ultraviolet imaging is useful for documenting

Bruises are present in 90% of physically abused children [1].
Bruises arise when blood is lost from the intravascular space into
the skin and subcutaneous tissues [1]. The breakdown of
hemoglobin and blood cells results in a sequence of colors,
including red, purple, black, blue, yellow, green, and brown [2].
Photographs play an important role in providing evidence of
abuse in injured children with suspected abuse. However, bruises
in children often heal quickly, and as time passes from the injury, it
is difficult to show evidence of a past bruise. Often, by the time a
child consultation center evaluates an abused child, and a
specialist performs an examination, the wound has healed.
In forensics, ultraviolet radiation is used conventionally to
enhance injuries of the skin [3–5]. It has been reported that
ultraviolet radiation can help to visualize an old bruise. In addition,
reports have shown that ultraviolet radiation can estimate the
shape of the object that caused the bruise [6–8]. Successful
identifications of bite marks (faint, old, and difficult to recognize)
have been made 6 months after injury [9]. However, long-term
ultraviolet exposure is known to adversely affect the skin and eyes.
West et al. reported that the biological hazard of UVA (long
ultraviolet waves with wavelengths of 400 nm–320 nm) is quite
small, although it can be potentially hazardous to the eyes [10].
injuries related to violence, using ultraviolet radiation to study
normal children as a positive control is not recommended.
Therefore, in this study, we attempted to visualize old bruises
using ultraviolet radiation as well as alternative light sources. This
is the first report to observe old bruises over a long time period
using different light sources with multiple wavelengths in healthy
volunteer children.
2. Materials and methods
2.1. Light sources, camera, and filter
Illuma-LightTM, a series of bright white and 470-nm blue LED
lights that provide 360-degree shadow-free lighting (blue ring;
Crime Sciences IncTM, Fonthill, ON, Canada) (Fig. 1), and a forensic
light source, Crime-lite1 2 (ultraviolet, violet, blue; Foster
Freeman, Worcestershire, UK), were used as light sources in this
study. A spectrometer (BLACK-Comet C-SR-50; StellarNet, Tampa,
FL, USA) was used to confirm the distribution of the accurate
wavelength of the light sources. A Canon PowerShot1 G12 camera
was used with a Canon Zoom Lens 5 IS 6.1–30.5 mm 1:2.8–4.5,
with a narrow band filter (including Illuma-LightTM; Crime
Sciences Inc.).

2.2. Observation and photography of the bruise

* Corresponding author.
E-mail addresses: mimasaka@med.akita-u.ac.jp (S. Mimasaka), We examined 15 bruises in healthy volunteer children, who
tooshima@med.akita-u.ac.jp (T. Oshima), mohtani@doc.med.akita-u.ac.jp
acquired the bruises in typical daily accidents (for example, having
(M. Ohtani).

https://doi.org/10.1016/j.forsciint.2017.11.015
0379-0738/© 2017 Elsevier B.V. All rights reserved.
 S. Mimasaka et al. / Forensic Science International 282 (2018) 74–78
Fig. 1. Illuma-Light (a series of bright white and 470-nm blue LED lights that
provide 360-degree shadow-free lighting: blue ring).
an accident while exercising, accidentally falling down the stairs,
etc.). The mean age of the children was 11.1  2.5 (range, 7–13)
years.
The observation and photography of each bruise were carried
out in a darkroom. The bruise was observed by two observers. At
first, we confirmed the location (e.g., direction and distance from
the datum-point) of the bruise and observed and photographed it
under visible light. Subsequently, the bruise was illuminated with
four different forensic light sources: blue ring, blue, violet, and
ultraviolet. We wore yellow-filtered goggles and observed each
bruise under the four different forensic light sources separately;
photography was attempted with a yellow filter. The children wore
protective eyeglasses during the observation and photography. The
children were instructed to remain still for several seconds during
the photography.
To measure chronologic changes, the observation and photog-
raphy were performed daily for the first 7 days and approximately
Fig. 2. Distributions of the wavelengths of four kinds of forensic light sources: blue ring (red line), blue (blue line), violet (black line), and ultraviolet (pink line) light.
75
once weekly thereafter (>7 days) until the bruise could no longer
be observed macroscopically. We compared the elapsed time after
the injury in terms of how long we were able to observe the bruises
macroscopically with each light source. All bruises were allowed to
heal naturally, without treatment such as cold-packs during the
healing process.
2.3. Statistics
The time during which it was possible to observe each bruise
was compared using visible light and the aforementioned four light
sources: blue ring, blue, violet, and ultraviolet light. The differences
between the groups were compared using the Friedman test. SPBS
(The Statistical Package for the Biosciences: K. Murata, E. Yano.
(2002) Medical Statistics for Evidence-Based Medicine with SPBS
User’s Guide, Nankodo Publisher, Tokyo, Japan) was used for the
statistical analyses.
2.4. Ethics
We obtained written informed consent from the parents of
volunteer children who had bruises, and permission to conduct
this study was obtained from the Akita University Graduate School
of Medicine Ethics Committee.
3. Results
3.1. Distribution of wavelengths
Fig. 2 shows the distributions of wavelengths of the four kinds
of forensic light sources: blue ring, blue, violet, and ultraviolet
light. The peak wavelength of each light source was confirmed as
follows: blue ring, 450–500 nm; blue, 420–470 nm; violet, 400–
430 nm; and ultraviolet, 350–380 nm. The light quantity of the blue
ring light was approximately half that of the other sources of light.
3.2. Case (bruise no. 11 in Table 1)
This is the case of a 12-year-old boy, who fell down the stairs
and sustained an injury involving a bruise on his right leg (Fig. 3).
The bruise appeared to have healed by one week and was not
visible under visible light. However, at one week, the bruise was
76 S. Mimasaka et al. / Forensic Science International 282 (2018) 74–78

Fig. 3. Photographs of one case (bruise no. 11 in Table 1). The bruise was photographed using each light source at the following times: one week, one month, and four months
after the injury.

somewhat visible with the blue ring light, and it was clearly seen
using other light sources. One month after the injury, the bruise
could not be observed with visible or blue ring light; however, it
could be seen under blue, violet, and ultraviolet light. Four months
after the injury, the bruise was only observed using a violet light
source. Six months after the injury, the bruise was not observed
using any light source.
3.3. Time interval for observing an old bruise under light sources of
various wavelengths
Table 1 shows the locations and sizes of the bruises and the
time intervals during which old bruises were visible under light
sources of various wavelengths. As the bruises healed, they were
no longer visible under visible light, but remained visible under

Table 1
Location and size of the bruises and the time interval during which an old bruise was visible under light sources of various wavelengths.

Bruise no. Location Size (mm) Visible (h) Blue ring (h) Blue (h) Violet (h) Ultraviolet (h)
1 Right cheek 25  28 237 237 670 1199 430
2 Right arm 140  20 240 240 240 431 431
3 Right elbow 52  30 252 252 323 444 444
4 Abdomen 40  50 36 85 132 132 204
5 Buttocks 20  18 168 168 504 504 504
6 Right thigh 120  105 23 143 431 431 431
7 Right knee 14  16 94 94 407 646 407
8 Left lower leg 20  40 145 145 456 359 288
9 Right lower leg 14  15 120 120 2375 3577 1463
10 Right lower leg 15  10 145 120 2375 3577 1535
11 Right lower leg 23  20 168 168 2591 3973 1728
12 Right lower leg 20  15 168 168 2591 3769 1822
13 Right lower leg 10  18 168 216 1034 1056 554
14 Right lower leg 17  17 168 216 1056 1056 720
15 Left lower leg 16  25 142 142 814 1775 502
Average 151.6 167.6 1066.6 1528.6 764.2
 S. Mimasaka et al. / Forensic Science International 282 (2018) 74–78
Fig. 4. Comparison of the length of time a bruise could be observed. The vertical
axis shows the elapsed time after the injury. A violet light source could identify a
bruise for a significantly longer time than the other light sources (p < 0.001).
other light sources. The average length of time a bruise could be
visualized by violet light was approximately 2.1 months, as
compared to only approximately 1.1 months for ultraviolet light. In
particular, the bruises were visible under a violet light source for a
significantly longer duration than with other light sources
(p < 0.001) (Fig. 4).
4. Discussion
Bruises are known to turn yellow and brown during the healing
process. This occurs because the hemoglobin of erythrocytes is
broken down into bilirubin, biliverdin, and hemosiderin [11].
Hughes et al. [12] reported that there is variability in the
perception threshold for yellow in the general population, and
that a subject’s ability to perceive yellow in a bruise declines with
age. Furthermore, as bruises heal and become a lighter color after
injury over time, it becomes difficult to observe the bruises by the
naked eye under visible light. Photographic evidence of an old
bruise is also limited, as the bruise’s color approximates the true
color of the skin.
In forensics, ultraviolet radiation is conventionally used to
enhance injuries of the skin [3–5]. However, the present study
determined that ultraviolet radiation is not necessary. This is good
news for patients who are concerned about harmful ultraviolet
radiation. Furthermore, violet light was superior to ultraviolet
radiation in detecting and visualizing an old bruise.
Although part of the wavelength of blue light overlaps with that
of blue ring light, blue ring light showed a shorter time period
during which an old bruise could be observed clearly. This is likely
due to the difference in the quantity of the light rather than the
difference in wavelength. Although the ring light has the advantage
of not creating a shadow, it is inferior in detecting an old bruise due
to its lower average light quantity.
Interestingly, in a study using a pigskin model, Olds et al. [13]
reported that violet and blue light sources produced the greatest
enhancement of bruises. They stated that, although ultraviolet and
blue–green light sources could also enhance the visibility of
bruises, this was to a lesser extent than violet or blue light sources.
The authors considered that this finding was due to the emission of
77
ultraviolet and blue–green light being just outside of the Soret
peak of hemoglobin (they are on either of violet and blue in terms
of wavelength) [13]. In addition, in a separate study of non-
embalmed and embalmed cadavers, the authors reported that
violet alternate light produced the greatest enhancement of
histologically confirmed bruises, followed by blue light [14]. Our
study supported their results in living bodies. Violet light helps to
visualize the bruise safely and is suitable for detecting old bruises
that are invisible to the naked eye. Of note, old bruises cannot be
visualized based on hemoglobin. Instead, they might be associated
with biochemical compounds created during the process of
healing of the skin. However, this could not be determined in
the present study as the subjects were living children; further
studies are needed to confirm this hypothesis.
Finally, some potential problems should be noted when using
this method in living children. Young children may be afraid to
undergo photography in the darkroom. Before taking any photo-
graphs, staff members should explain to children, in terms that
they can understand, that the room will be dark during
photography. In addition, a photographic scan in the darkroom
has a long shutter time, and children are apt to move slightly. It is
necessary for the staff to ensure that the children remain still
during photography. In the present study, the volunteers were
older children and had no problems during the photography.
5. Conclusion
Bruises in children following an accidental injury can be
observed for a longer duration using violet light compared to
visible, blue ring, blue, and ultraviolet light. Visualization of a
bruise over a longer term could help to prove a past violent act in
children whose bruises are no longer visible to the naked eye.
Funding
This work was supported by JSPS (Japan Society for the
Promotion of Science) KAKENHI Grant Numbers JP3390182 and
JP16K01857.
Conflicts of interest
None.
Acknowledgment
We would like to thank Prof. Katsuyuki Murata (Department of
Environmental Health Sciences, Akita University Graduate School
of Medicine, Akita, Japan) for providing useful comments on the
statistical analysis as well as Editage (www.editage.jp) for English
language editing.
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