Skin messages in suicide--an unusual occurrence.

Notes are found in only a minority of cases of suicide and occasionally may involve writing messages on skin surfaces. A prospective study was undertaken for cases of suicide with skin messaging over a 12-year period from 1/1/2000 to 31/12/2011. A total of 498 cases of suicide were examined with only 2 cases (0.4%) having suicide notes written on their skin. Both cases involved young males (aged 18 and 30 years respectively) with the deaths occurring by hanging. In both cases typical parchmented ligature marks were present around the neck running up to the point of suspension. Both decedents had written messages on their hands/arms expressing mixtures of sorrow and hopelessness. There were no other suicide notes present. It is not clear whether writing on skin rather than on more conventional material suggests that the suicide may not have been planned, or instead that the decedent wanted to ensure that the message was found. Messages on skin may be slightly different to messages written on other surfaces, as space is limited and pens and markers may not write as effectively. An additional problem with skin messages is their vulnerability to erasure, making clear documentation of these findings at the scene important.