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Creator An entity primarily responsible for making the resource Mohandoss, Anusa Arunachalam; Thavarajah, Rooban Title A name given to the resource Paraquat associated stomatitis: A forensic marker of exposure intent and prognosis Date A point or period of time associated with an event in the lifecycle of the resource 01-01-2026 Source A related resource from which the described resource is derived Journal of Forensic and Legal Medicine;Volume;119;Issue;;Article No.;103113; Identifier An unambiguous reference to the resource within a given context <a href="https://doi.org/10.1016/j.jflm.2026.103113" target="_blank" rel="noreferrer noopener">https://doi.org/10.1016/j.jflm.2026.103113</a> <br /><br /><a href="https://www.scopus.com/pages/publications/105035119169?origin=resultslist" target="_blank" rel="noreferrer noopener">https://www.scopus.com/pages/publications/105035119169?origin=resultslist</a> Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant Mohandoss A.A., Department of Psychiatry, Shri Sathya Sai Medical College and Research Institute, Affiliated to Sri Balaji Vidyapeeth, Deemed to be University, SBV Nagar, Chennai Campus, Tamil Nadu, 603108, India; Thavarajah R., Marundeeswara Oral Pathology Services and Analytics, B-1, Mistral Apartments, Wipro Street (Off Rajiv Gandhi IT Highway), Shollinganallur, Chennai, 600119, India, Department of Oral and Maxillofacial Pathology, Ragas Dental College &amp; Hospital, (Affiliated to the Tamil Nadu Dr. MGR Medical University, Chennai) 2/102 East Coast Road, Uthandi, Chennai, 600119, India Description An account of the resource Introduction: Paraquat-associated stomatitis (PAS) is a hallmark of paraquat poisoning but its potential as an intent-specific or prognostic marker remains unexplored. This study investigated whether PAS patterns differ between accidental and suicidal exposures. Methods: A pooled, individual case analysis of 170 paraquat poisoning cases from 122 publications was conducted following PRISMA guidelines. Data on demographics, exposure intent, and detailed oral lesion characteristics (morphology, pattern, severity) were extracted. Statistical analyses identified predictors of intent and prognosis. Results: Oral lesions were present in 78.8% of cases. While the overall prevalence of PAS did not differ between accidental (85.1%) and suicidal (83.9%) intents, lesion morphology was a key differentiator. Widespread ulcers were strongly associated with suicidal ingestion (aOR=6.37; 95% CI 1.9520.78; P=0.002), independent of lesion severity or WHO grade. Conversely, focal but objectively more severe ulcers characterized accidental exposures. Lesion morphology, not severity, distinguishes intent. Other independent predictors of suicidal intent included female sex (aOR=3.40; P=0.031), oliguria (aOR=4.21; P=0.006), and delayed treatment (aOR=8.39; P=0.023). Paradoxically, accidental exposures were associated with significantly higher mortality (68.9%) compared to suicidal cases (39.8%) (P=0.001). The absence of PAS reliably indicated a non-oral exposure route (P&lt;0.001). Discussion: This work introduces the novel concept of intent-specific PAS morphology, establishing ulcer pattern as a forensic marker. It is demonstrated, for the first time, that widespread lesions objectively indicate suicide, while focal, severe ulcers signify accidental exposurea finding linked to a paradoxical mortality risk. This intent-specific signature could provide clinicians with a rapid, objective tool for stratification. For medicolegal investigations, it qualifies PAS as crucial physical evidence to clarify disputed histories, advocating for its systematic documentation in clinical and autopsy practice as a new standard in forensic toxicology. 2026 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights are reserved, including those for text and data mining, AI training, and similar technologies. Subject The topic of the resource Forensic toxicology; Oral mucositis; Paraquat; Poisoning; Stomatitis Publisher An entity responsible for making the resource available Churchill Livingstone Relation A related resource ISSN: 1752928X; Language A language of the resource English Type The nature or genre of the resource Article Rights Information about rights held in and over the resource Restricted Access; Hardcopy may be available in the library Format The file format, physical medium, or dimensions of the resource online