Anatomy of the Lips for Autopsy

Need for Autopsy in every death –

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Anatomy of the Lips for Autopsy

Before exploring the morphological details of a pair of lips, it is more important to understand the elementary functions of the lips. The lips functional characteristics are:

Food intake – When food and drink are together inside, lips serve to close the mouth airtight to hold.

Mastication – Lips help to hold food between upper and lower teeth during chewing.

Articulation – The lips felicitate creating sounds – mainly labial, and labiodental consonant.

Tactile organ – The lip reacts as part of the tactile senses, having many nerve endings, are very sensitive to touch, warmth and cold.

Erogenous zone – Because of the higher proportion of nerve endings, acts as erogenous zone, playing a crucial role in osculation and other acts of intimacy.

Facial expressions – The lips form an integral part of several facial expression e.g., smiling, frowning, giggling etc.

The lips of all the genders undergo different changes, in size, colour, and surface, indicating a medical problem. But there are many other changes those which have demonstrated to be harmless. Most distinctively, the lips grow thinner with aging.

• Lip sores (ulcers): are caused due to several reasons. Sores develop due to certain medical conditions, such as erythema multiforme, recurrent oral herpes simplex virus infection (cold sores), or syphilis.

But, a lip sore with hard edges may be a form of skin cancer, whereas, mouth and throat cancers may look like open sores, growths, or discoloured areas in the mouth. Biopsies are performed to diagnose mouth and throat cancers, along-with Imaging Tests, such as computed tomography, magnetic resonance imaging, and positron emission tomography, are used to determine the size of the cancer and how far the cancer has spread. Subsequent treatment depends on the location, size, and extent of spread of the cancer and may include surgery, radiation therapy, and chemotherapy.  

• Spots on the lips: Multiple, small, scattered brownish-black spots may be a sign of a hereditary disease called Peutz-Jeghers syndrome, in which polyps form in the stomach and intestines. Rarely, people who smoke develop noncancerous brown spots on the lips near where the cigarette is held. Freckles and irregularly shaped brownish areas (melanotic macules) are common around the lips and may last for many years. These marks are not cause for concern.

• Kawasaki disease: a disease of unknown cause but may be associated with an infection that usually occurs in infants and children 8 years old or younger, can cause dryness and cracking of the lips and reddening of the lining of the mouth. The cause of Kawasaki disease is unknown.

Children typically have fever, rash, and a red strawberry tongue, and some develop heart complications that rarely can be fatal. With prompt treatment, administering high doses of immune globulin and aspirin nearly all children recover.

Kawasaki disease causes inflammation in the walls of blood vessels (vasculitis) throughout the body. Inflammation of blood vessels in the heart causes the most serious problems. The inflammation also can spread to other parts of the body such as the pancreas and kidneys.

Most children with Kawasaki disease are between 1 and 5 years of age, although infants and older children and adolescents can be affected. Although the illness is more common among children of Japanese descent, but in India there had been a formidable presence of this disease.

• Cheilitis: it is the inflammation of the lips, causing it to become painful, irritated, red, cracked, and scaly. The reasons for the cause of Cheilitis are – Dentures that do not separate the jaws adequately; Excessively worn-down teeth, resulting in less space between the upper and lower teeth; A Candida or a Staphylococcus aureus infection; A deficiency of vitamin B2 or iron in the diet.

The treatment can be rendered by replacing the dentures, which helps reduce the folds at the corners of the mouth, or restoring proper tooth size with partial dentures, crowns, or implants. Infections can be treated with medications applied to the corners of the mouth. Vitamin B2 deficiency and iron deficiency can be treated by supplements of those nutrients.

Cheiloscopy, is the scientific study of the lip prints which are present as lines and fissures in the form of wrinkles and grooves on the labial mucosa of both upper and lower lips, developed since the sixth week of intra-uterine life.

Lip print patterns can be a valuable adjunct in forensic investigations for individualisation and identification of a person in criminal as well as civil investigations like assaults (physical and sexual), thefts, burglaries, homicides etc. They are unique, stable and permanent features of an individual, except in identical twins.

The patterns do not change in general during an entire lifetime, excepting becoming thinner with the increment in the chronological age. But, in the probable case of a major trauma, a scarring pathosis or surgical treatment can alter the size and shape, pattern and morphology of the lip pattern. Lip prints found on clothing’s, handkerchief, sanitary napkins, mugs, photographs, letters, window-panes, cutlery, fruit skin/peel, cigarette butts, glass or cigarette butts found recovered from crime scene may link a suspect or victim to the scene of crime. The sebaceous and salivary secretions at vermillion zone or middle portion of human lips help in latent lip print formation on all physical objects likely to be touched during deliberate or in-deliberate mouth activity. Like finger prints, palatal rugae and DNA profiles, lip prints are proven be instrumental in the identification and, verifying the presence or absence of a person at the scene of occurrence.

Although, several studies have been conducted to verify the authenticity of lip prints, and in their relationships with palatal rugae, blood groups or fingerprint patterns of a person; however, the credibility of lip prints as a reliable evidence for human identification purposes has not yet been firmly established in the courts of law in India, the reason because there was no such study available to show any relationship between occupational peculiarities and lip print pattern types.

However, the fallacies were overcome with the Government initiating a study to assess the suitability of lip prints for personal identification of an individual with the following objectives:

• To determine predominant lip print,

• To evaluate whether any sexual differences exist in lip print pattern types and to assess any sex or occupation dependant variations in patterns among individual quadrants,

• To analyse population variations in lip print pattern types.

The present study was carried out on lip prints collected from several consensus adults across different genders. Some were occupationists, like brass-players, musicians, tailors, carpenters and beauticians, who indulges in active & continuous use of their lips during their professional endeavours.

The individuals who possess any past history of disease/ deformities/ injury of lips (like dry lips, cleft lips, lips with laceration or scar, etc) were discarded for collection of prints.

The material used for collection, development and analysis of lip-prints include: red/pink lipstick (non-glossy, non-persistent, non-metallic), cellophane tape, white paper, scanner, hand magnifying glass, scissors, Adobe Photoshop CS5 Software etc.

To be continued………………

Writer Suvro Sanyal

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