Lichtenberg Figures from Lightning Strike

This is an answer to the Case – Painless Erythematous Cutaneous Marks in a Fern-Leaf Pattern

A 19-year-old woman was brought to the emergency department after a nearby lightning strike in which her Great Dane dog had been instantly killed. She briefly lost consciousness and found herself on the wet ground, calling for help.

On arrival at the hospital, she was in sinus rhythm with normal vital signs and paresthesia in both legs. The electrocardiogram was normal. Serum levels of creatine kinase and troponin I and the electrolyte panel were within the normal range.

The clinical examination revealed several painless erythematous cutaneous marks in a fern-leaf pattern on the inner sides of both legs, so-called Lichtenberg figures.

When the patient was discharged 18 hours later, the branching cutaneous erythema had completely disappeared.