Clinical assessment and diagnostic features of fellatio-associated palatal lesions in forensic sexual abuse investigations: a systematic review.
Almasyifa Herlingga Rahmasari Amin, Elza Ibrahim Auerkari
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In 30 seconds
This PROSPERO-registered systematic review, conducted according to PRISMA 2020 guidelines, examined clinical assessment and diagnostic features of palatal lesions associated with fellatio in forensic sexual abuse investigations. Of 480 records identified, 30 studies were included in the qualitative synthesis. The review describes lesions commonly occurring at the hard–soft palate junction as erythema, petechiae, or purpura, attributed to localized negative pressure and mechanical trauma. They generally resolve spontaneously within 48 h to two weeks. The authors conclude that oral examination may add information to the overall forensic assessment, while these lesions are not specific to sexual trauma.
Key findings
- The review included 30 studies in its qualitative synthesis from 480 records identified.
- Fellatio-associated palatal lesions typically include erythema, petechiae, or purpura at the hard–soft palate junction.
- Lesions generally resolve spontaneously within 48 h to two weeks.
- Palatal lesions are not exclusive to sexual trauma, but may provide additional information in forensic assessment.
Why it matters
Anogenital findings alone may leave gaps in forensic assessment, and the review highlights the potential value of examining the oral cavity. Recognising the described palatal findings and documenting them systematically can contribute clinical information to the broader evaluation, while their lack of specificity means they should not be interpreted in isolation.
What to keep in mind
The review reports a qualitative synthesis; the abstract provides no pooled estimates of diagnostic accuracy or quantitative assessment of the evidence.