# Circular Skin Lesions Mimicking Blunt Trauma: A Forensic Case of Cupping Therapy

## TL;DR

A forensic case shows how cupping therapy can create skin discolorations that look like bruises, highlighting the need to consider cultural practices in medical evaluations.

## Contribution

This case emphasizes the importance of distinguishing cupping therapy marks from traumatic injuries in forensic and clinical settings.

## Key findings

- Circular purplish discolorations on the upper back were initially mistaken for blunt trauma.
- Postmortem dissection showed no underlying hemorrhage, indicating non-traumatic origin.
- The patient's history of cupping therapy explained the skin findings.

## Abstract

Skin findings provide important diagnostic clues in both clinical and forensic practice, often serving as an initial trigger for evaluating the possibility of physical assault or child abuse. However, not all discolorations that resemble bruises result from blunt trauma. Cupping therapy, a traditional complementary treatment widely practiced in East Asia, can produce purplish skin discolorations caused by superficial capillary rupture from localized negative pressure. We present a forensic autopsy case of a man who died following a fall from height. During postmortem examination, multiple circular purplish discolorations were observed on his upper back, initially raising suspicion of blunt trauma or assault. However, postmortem dissection revealed no hemorrhage in the subcutaneous fat or muscle tissue beneath the lesions, and further investigation identified a history of recent cupping therapy. This case highlights the importance of recognizing cultural practices such as cupping therapy that may mimic traumatic injuries and underscores the need for careful differentiation in both forensic and clinical evaluations to avoid diagnostic errors.