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Results for “RADIODERMATITIS”

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At least 217 records · Page 12Linked to original sources

PubMed1982

Polyvinylpyrrolidone (povidone) storage in RX-damaged skin following procaine-povidone intramuscular injections.

A man, aged 67, has been treated in 1968 by X-rays for a basal-cell carcinoma of the back. The treatment was followed by an ulcerative radiodermatitis. 3 years later, the patient was treated by ten intramuscular injections of procaine-polyvinylpyrrolidone (or procaine-povidone) for sciatic neuralgia. An orange infiltration appeared progressively around the radiodermatitis. The area was excised in 1979 and polyvinylpyrrolidone (povidone) storage, responsible for the ring-shaped orange hue, could be demonstrated in the dermis and subcutaneous fat. Special stainings confirmed the presumed chemical nature of the deposits. 3 cases of povidone pseudotumours following procaine-povidone injections had been described previously. The preferential deposit of povidone in RX-damaged skin is discussed.

Aged↗

PubMed2004

The effect of zinc sulphate in the prevention of radiation-induced dermatitis.

There is currently substantial clinical interest in zinc (Zn) as a protective agent against radiation-related normal tissue injury. To further assess this drug's potential, the effect of Zn was studied in rats using a radiation-induced skin injury model. Sprague-Dawley rats were divided into four groups. Group 1 received neither Zn nor irradiation (control group). Group 2 received 30 Gy of gamma irradiation as a single dose to the right hind legs of the rats (RT Group). Groups 3 and 4 received the same irradiation plus 5 mg/kg/day Zn (RT+5 Zn group) or 10 mg/kg/day Zn orally (RT+10 Zn group), respectively. The rats were irradiated using a cobalt-60 teletherapy unit. Acute skin reactions were assessed every three days by two independent radiation oncology experts. At the endpoint of the study, light-microscopic findings were assessed by two independent expert pathology physicians. Clinically and histopathologically, irradiation increased dermatitis when compared with the control group (p < 0.05). The severity of radiodermatitis of the rats in the RT+5 Zn and RT+10 Zn groups was significantly lower than in the RT group (p < 0.05); radiodermatitis was seen earlier in the RT group than in the other groups (p < 0.05). Zn was found to be efficacious in preventing epidermal atrophy, dermal degeneration such as edema and collagen fiber loss, and hair follicle atrophy. The most protection for radiation dermatitis was observed in the RT+10 Zn group. It would be worthwhile studying the effects of zinc sulphate supplements in radiation-treated cancer patients, in the hope of reducing radiation-induced toxicity.

Administration, Oral↗

PubMed2001

[Radiation-induced skin toxicities: prevention, treatment].

Acute and long term effects are frequent after radiotherapy. They may alter the general status and quality of life of the patients. Chronic radiodermatitis may result in ulceration and in transformation into a squamous cell carcinoma. There is a correlation of the frequency of acute dermatitis with the total dose. Chronic radiodermatitis may develop after repeated small doses of ionizing radiation for cardiac catheterization and coronary angioplasties. The other prognostic factors for the level of acute and late skin reactions are volume of tissue treated, total daily dose, fractionactions schemes ... but there are some variation in the degree of reaction in patients treated with identical radiotherapy schedules. There is a patient-to-patient variability. Several diseases as systemic sclerosis, some genetic diseases, perhaps some drugs may increase the cutaneous reactions. So both acute and chronic irradiation injury is a complex process with many regulations. Chronic fibrosis may be caused by mechanism of cell activation (and particularly fibroblasts). Cytokines e.g. transforming growth factor beta (TGF-beta) might be involved in the induction of fibrosis. Treatment use emollients. Superoxide dismutase was used as an ointment for radiofibrosis therapy and obtains a reduction of the fibrosis. In late phases plastic surgery or sometimes cryosurgery can be used.

Administration, Topical↗

PubMed2002

[Radiation-induced temporary hair loss after endovascular embolization of the cerebral arteries: six cases].

BACKGROUND: Intraoperative fluoroscopy imaging during coronaroplasty or transjugular intrahepatic portosystemic shunt may induce chronic radiodermatitis. Temporary hair loss is a peculiar form of radiodermatitis following endovascular surgery of the cerebral arteries. CASE REPORTS: Six patients (2 women, 4 men, age range: 27-47 years old) were seen for a solitary plaque of alopecia. In all of the cases, the plaque had appeared two weeks after a neuroradiologically guided embolization procedure. No other skin lesions were seen. Alopecia spontaneously and completely regressed within three to four months. However, it reappeared after a subsequent embolization (one case) but not after arteriographies (five cases). DISCUSSION: Five similar cases have been reported in the literature. Transient alopecia often occurs after neurologically guided endovascular surgery of the cerebral arteries. This side-effect is well known by neurosurgeons and thus, these patients are rarely referred to a dermatologist. Two differential diagnoses must be evoqued: alopecia aerata and anticonvulsant - induced alopecia. The role played as cofactor by carbamazepine which is a photosensitivant drug, is discussed.

Adult↗

PubMed2006

[Radiation arteritis- and radiodermitis-induced leg ulcer: surgical revascularization].

A forty-four-year old man was hospitalized for diagnosis and treatment of a left leg ulcer which did not heal despite good compliance with a three-month medical regimen. Twenty years before he had undergone surgical curettage and radiotherapy (81 gy) for an osteosarcoma of the upper third of the left tibia. He was considered completely cured with regular findings. On examination he had a 5 X 7 cm deep ulcer with raised margins and no signs of infection, localized on the radiodermatitis on the medial aspect of his left leg. Arterial examination confirmed the left arteriopathy with absence of distal pulses; the Ankle Brachial Pressure Index was 0.69 and the foot TcPO2 27 mmHg. Arteriography confirmed the localized left lesions with three distal popliteal and proximal arterial occlusions, all other arteries being strictly normal. Arterial and dermatological radiation leg ulcer was retained as the etiological diagnosis. As the ulcer was very painful, extensive and limited walking distance, surgical revascularisation was undertaken because endoluminal revascularization was impossible. A femoroperoneal saphenous bypass was performed with surgical incisions beyond the radiodermatitis area. Two months after a split skin graft, the ulcer was considered healed and the patency of the by-pass confirmed on duplex examination. This is the first case report of a successful distal by-pass performed for radiation arteritis and ulcer healing. Long-term follow up should be reported.

Adult↗

PubMed2003

Multiple pigmented basal cell carcinomas arising in the normal-appearing skin after radiotherapy for carcinoma of the cervix.

BACKGROUND: The most frequent radiation-induced skin cancers are basal cell carcinomas (BCCs), and in many cases, they may occur subsequent to tinea capitis, hypertrophic tonsillitis, acne vulgaris, atopic dermatitis, and hyperthyroidosis. BCCs occurring after radiotherapy for carcinoma of the cervix are extremely rare. OBJECTIVE: To describe a case of multiple pigmented BCCs caused by radiotherapy for carcinoma of the cervix. RESULTS: A 76-year-old female presented with four tumoral lesions within a previously irradiated area. The patient had undergone radiation therapy for cervical cancer 38 years before. All of the lesions were totally excised and histopathologically diagnosed as BCCs. There was no apparent gross chronic radiodermatitis around the lesions, but characteristic histopathologic alterations of radiodermatitis were observed. No new tumors were observed to date. CONCLUSION: The latent period for radiation-induced skin cancer is generally very long; secondary skin cancers can develop very late in life. Patients previously treated with radiation therapy require careful follow-up for life.

Aged↗

PubMedDate not supplied

A long-term effect of prior irradiation on the thermal enhancement of radiation damage in the mouse ear.

The responses of the mouse ear to heat alone, X-rays alone or X-rays combined with heat were measured at 10 months after initial X-ray treatments (19 Gy or 10 X 3.8 Gy), which caused similar acute reactions. Fractionating the initial dose had little effect on the response to retreatment. Prior irradiation increased thermal sensitivity so that the heating time at 43.5 degrees C required to cause necrosis was about 65 per cent that in age-matched controls. Prior irradiation also increased the response to X-rays alone, but had different effects on the susceptibilities to develop acute radiodermatitis and late deformity. For acute radiodermatitis, the second X-ray dose required to cause a given response in previously irradiated ears was 80-90 per cent that in age-matched controls and for late deformity it was 60-65 per cent. Prior irradiation had the same effects on the responses to X-rays given 6 min before mild hyperthermia (43.5 degrees C, 12 min) as on those to X-rays alone but had little effect on the responses to X-rays given 6 min after hyperthermia. Consequently, the thermal enhancement ratios for heat given after X-rays did not depend on prior irradiation whereas those for heat given before X-rays were reduced. This reduction may be due to a reduced ability of irradiated blood vessels to elicit an hyperaemic response to heat.

Animals↗

PubMed1989

Sequelae of radiation facial epilation (North American Hiroshima maiden syndrome).

Radiation for benign problems of the head and neck area has been uniformly recognized as unacceptable practice. This includes epilation for facial hirsutism. Twelve such patients, recently encountered, have characteristic radiodermatitis facies and have demonstrated multisite neoplastic involvement--including skin, thyroid, parathyroid, salivary gland, oral cavity, facial skeleton, and breast--and have also undergone extensive dermatologic treatment of complications of radiodermatitis. There was one cancer death, and three patients are alive with cancer. Such patients have a superficial resemblance to the Hiroshima maiden group of young women who survived atomic bombing and experienced severe facial burns, necessitating extensive plastic surgery. As atomic survivors they are at increased risk for cancer of thyroid, salivary gland, lung, breast, bone marrow, and gastrointestinal tract. The North American Hiroshima maiden should warrant easy clinical recognition and require lifetime scrutiny for multisite neoplastic disease.

Aged↗

PubMed1976

Sebaceous gland carcinoma of the eyelid.

A 37-year old woman had received multiple radiation treatments between the ages of 6 months and 15 years for an extensive cavernous hemangioma of the left side of the face. At the age of 27 years, a biopsy specimen from a lesion of the left buccal commissure disclosed squamous cell carcinoma arising in chronic radiodermatitis. Multiple cutaneous lesions were excised surgically, and extensive skin grafting of the left side of the face was performed. At the age of 35, she developed a tumor of the left upper and lower eyelids that extended into the orbit, which proved to be a sebaceous gland carcinoma. Following left orbital exenteration, the tumor promptly recurred in the socket. The patient died with widespread metastatic lesions nine months after exenteration. This case, which, to our knowledge, represents the fourth example of postradiation sebaceous gland carcinoma of the eyelids, differs from the previously reported cases in that the radiation therapy had been given for a benign cutaneous condition.

Adolescent↗

PubMed1976

The tricho system: hypertrichosis, radiation, and cancer.

Five women in their 6th to 8th decades were treated for facial hypertrichosis in Erie, Pennsylvania, 30 to 40 years ago. The epilations were performed with an X-ray device called "Tricho System," which was manufactured, sold, and proclaimed safe by its physician-inventor. The beauty shop operator who administered these treatments may or may not have received "instruction" by the company in the operation of the equipment. At varying intervals, each of the 5 women developed radiodermatitis and basal cell and/or squamous cell carcinoma at the sites of epilation. All presented to the plastic surgical service at the Hamot Medical Center in Erie, Pennsylvania. Two underwent massive radical resective surgery, 2 required extensive excision and resurfacing, and 1 refused resective surgery although she had had a previous surgical attempt 17 years earlier. Case histories are presented in detail. This series is representative of the epidemic nature of Tricho-System-induced disease.

Aged↗

PubMed2005

Covering small defects on the weight bearing surfaces of the foot: the free temporal fasciocutaneous flap.

Although defects in the weight bearing area of the heel can be covered by local flaps, radiodermatitis is a contraindication to these flaps. Thin free flaps, as grafted fascial or muscles flaps and thin fasciocutaneous flaps, are usually the option of choice in these particular defects. These reconstructions are prone to shearing strains resulting in ulceration, hypertrophic scars and hyperkeratosis. The authors present a retrospective study of the reconstruction of six small heel defects with the fasciocutaneous temporal free flap performed between 1996 and 2001. The mean size of the defect was 20 cm(2). All arterial anastomoses were performed end to side on the posterior tibial artery. Despite the flap thinness, swelling was present during 12-25 months and one debulking had to be performed. With a mean follow-up of 32 months, all flaps regained protective sensibility after 7 months. No sliding of the flaps could be noted but there was one transient hyperkeratosis. Although the amount of hair on the transferred flaps decreased spontaneously with time, laser hair removal was performed in two patients for psychological reasons. In conclusion, it seems that in selected cases where local flaps are contraindicated, the fasciocutaneous temporal free flap can offer an excellent alternative for heel reconstruction. Due to its particular architecture, it resembles the complex tissue of the sole of the foot resulting in fewer complications and maintenance of flap durability.

Adult↗

PubMed2003

Pulsed dye laser treatment of telangiectasia after radiotherapy for carcinoma of the breast.

BACKGROUND: Chronic radiodermatitis after radiotherapy for carcinoma of the breast is a common sequela of treatment and can be distressing for the patient. The skin is atrophic and shows prominent telangiectasia due to dilatation of a reduced or poorly supported skin vasculature. The pulsed dye laser (PDL) is an established treatment of cutaneous telangiectatic disorders including facial telangiectasia and spider naevi, and is safe and efficacious. OBJECTIVES: To study the efficacy of the PDL in the treatment of postradiation telangiectasia of the breast or chest wall. METHODS: Prospective open study of the treatment of eight females with the Candela SPTL1B PDL. Subjective assessments of vessel clearance, adverse effects and patient questionnaires. RESULTS: All treated patients showed complete clearance of vessels. Two patients developed hypopigmentation. All patients reported a high degree of satisfaction with the treatment. CONCLUSIONS: PDL therapy clears postirradiation telangiectasia of the breast and chest wall successfully with minimal adverse reactions, and can be recommended for patients distressed by this disorder.

Adult↗

PubMed2000

Efficacy of homeopathic treatment of skin reactions during radiotherapy for breast cancer: a randomised, double-blind clinical trial.

The aim of this study was to assess the effects of Belladonna 7cH and X-ray 15cH associated in the treatment of acute radiodermatitis. A randomized double-blind placebo-controlled clinical trial involving 66 patients who had been operated on for breast cancer and were undergoing radiotherapy was conducted. The following parameters were assessed over ten weeks: breast skin colour, warmth, swelling and pigmentation. The efficacy of the treatment was assessed by the comparison of these parameters taken individually and by calculating an Index of Total Severity (sum of the scores of the four parameters) during radiotherapy, and during recovery, 15 and 30 d after the end of the radiotherapy. The differences of the scores of the Index of Total Severity during Radiotherapy were not statistically significant, but showed a trend towards a better activity of the homoeopathic medicine compared to placebo. Analysis of the data on Total Severity during recovery, showed a statistically significant benefit of the active medicines over placebo. The homeopathic medicines had particular effectiveness on the heat of the skin. The limited number of patients observed and the posology employed could have interfered with the significance of the results. Chemotherapy and hormonotherapy do not seem to affect the results.

Adult↗

PubMed2004

Severe radiation dermatitis is related to Staphylococcus aureus.

Acute radiation dermatitis commonly occurs following local radiation therapy for various cancers and, when severe, may necessitate disruption of treatment. Intense inflammatory reaction may result in a breakdown of the skin's barrier function and accompanying bacterial colonization. Bacterial superantigens may exacerbate inflammation through activation of T-cells and subsequent cytokine release. We report six cases of severe radiation dermatitis in cancer patients. Four of the six grew pathogenic bacteria, and three had psoriasiform or eczematous reactions at distant sites. Both the radiation dermatitis and the distant cutaneous reactions resolved rapidly on a combination of topical steroids and oral plus topical antibiotic therapy. We suggest that staphylococcal superinfection of acute radiodermatitis intensifies the inflammatory process and hinders repair of the epidermal barrier. Patients with acute radiation dermatitis should be investigated for secondary infection. We emphasize the importance of including topical and oral antibiotic therapy in conjunction with topical corticosteroids to eradicate infection as well as hasten repair of the skin's barrier function. These cases are presented to call attention to the role of Staphylococcus aureus in the pathogenesis of severe radiation dermatitis and the need to include appropriate antibiotic therapy based on culture in the management of acute radiation dermatitis.

Aged↗

PubMed2003

Simple approach to the radiated scalp wound using INTEGRA skin substitute.

The chronic irradiated scalp wound remains one of the most difficult reconstructions for the plastic surgeon. With its inherent radiodermatitis and poor healing potential, chronic ulcers down to bone will result if coverage cannot be achieved. Reconstructive procedures as simple as a skin graft have a high complication rate in the irradiated wound and often fail. Local tissue transfer also has a high failure and complication rate because of the decreased vascularity of the wound bed and radiation damage to the surrounding scalp tissue, limiting its manipulation. The authors report two cases using a simple method with INTEGRA bilaminate skin substitute (Integra Life Sciences, Plainsboro, NJ) for repair of difficult wounds of the radiated scalp. Case one involves a patient with nonhealing radiation ulcers that had failed local wound care, hyperbaric oxygen, and split-thickness skin grafting. Case two involves a patient with extensive squamous cell cancer of the scalp that recurred despite total scalp radiation, requiring resection of more than 50% of the total surface area of the scalp. Both these patients were successfully treated using INTEGRA artificial skin substitute (Integra Life Sciences). This simple method using INTEGRA (Integra Life Sciences) resulted in complete healing of the radiated scalp wound and an acceptable, functional, and cosmetic outcome with minimal morbidity to the patients.

Adult↗

PubMed1995

Metastatic squamous cell carcinoma of the hand and review of the literature.

New cases of cancer amongst medical workers arising as a result of X-ray exposure are now rare. We record a case of a dentist who presented 11 years ago with a radiation induced squamous cell carcinoma of the ring finger of his left hand with massive axillary lymphadenopathy. Repeated exposure of his hands to diagnostic dental irradiation in his surgery had lead 16 years previously to a troublesome radiodermatitis which had been mistakenly diagnosed and had itself been treated with radiotherapy without effect. Management by amputation of the distal phalanx of the ring finger, debulking of the axillary lymphadenopathy with adjunctive radiotherapy to the axilla and chemotherapy, have been successful in achieving a prolonged disease free interval and satisfactory hand function.

Carcinoma, Squamous Cell↗

PubMed1991

Atypical radiation toxicity in patients with classical Kaposi's sarcoma.

The classical (non-AIDS-related) form of Kaposi's sarcoma (KS) typically affects older patients of Eastern European or Mediterranean ethnic background. Although radiotherapy is a standard part of the treatment armamentarium for KS patients, a high incidence of radiotoxicity has been reported in epidemic AIDS-related cases. In order to determine whether this radiotoxicity is observed only in patients with the epidemic form of the disease, we have conducted a retrospective chart review of 30 patients with classical KS treated with radiation for whom follow-up information was available. Seven out of 30 (23%) were found to have unexpectedly high levels of radiotoxicity after tumor doses of 22-42 Gy. This toxicity consisted either of significantly increased edema or chronic skin breakdown and severe radiodermatitis, in some cases requiring multiple surgical corrective procedures. We suggest that the abnormal lymphaticovenous development and chronic lymphokine stimulation associated with KS of both epidemic and classical forms may be responsible in part for the observed radiotoxicity.

Aged↗

PubMed1998

Dosimetric and radiation protection considerations based on some cases of patient skin injuries in interventional cardiology.

Recently, several cases of skin injuries have been detected in patients undergoing cardiac radiofrequency catheter ablation. These procedures were performed on a biplane X-ray system used in a large Spanish hospital for interventional cardiology procedures. Interventional procedures performed and radiation lesions produced on patients are described. The radiation lesions were mainly erythematous lesions and chronic radiodermatitis. Results of the dosimetric evaluations and an analysis of the operational aspects of radiological protection are discussed. Poor image quality could have influenced the length of the procedures. Dose rate at the image intensifier entrance was within usual reported values in literature. However, the focus-to-skin distance for the horizontal X-ray beam was too short, resulting in a high skin dose rate. Additionally, X-ray beams are of fixed orientation, and accumulated skin dose in the patient's right side has been estimated as 11-15 Gy per procedure. In conclusion, practical radiation protection considerations to avoid further incidents of this sort are proposed, concerning the use of X-ray systems specially designed for interventional radiology, the improvement of cardiologists' training in radiation protection and routine patient dose measurements for complex interventional procedures.

Adolescent↗