1.3.5 Radiation Dermatitis

Grading & Level of Importance: B

Review:
2021

W. Burgdorf, Munich; D. Trokoudes, J. McGrath, A. Salam, London

Definition

Acute or chronic skin damage caused by short wavelength electromagnetic radiation (x-rays or gamma rays).

Aetiology & Pathogenesis

DNA damage from high energy radiation.

Signs & Symptoms

Varies with acuity:

  • Acute radiation dermatitis: erythema 10 days after exposure.
  • Chronic radiation dermatitis: poikiloderma (hypo- and hyperpigmentation, atrophy and telangiectasia occurring more than 2 years after exposure.

Localisation

Irradiated area.

Classification

Acute and chronic radiation dermatitis.

Course

Most acute radiation dermatitis heals completely; chronic radiation dermatitis leads to scarring and thus permanent changes.

Complications

In chronic radiation dermatitis, there is a risk of developing radiation ulcers and radiation keratosis and rarely, squamous cell carcinomas or other radiation-induced tumours.

Diagnosis

History, clinical features.

Differential diagnosis

Burn, scars.

Prevention & Therapy

Acute radiation dermatitis: topical corticosteroids, sometimes systemic corticosteroids for their anti-inflammatory action.

 

Chronic radiation dermatitis: light protection, sometimes excision of specific lesions.

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