What Is Radiation Dermatitis?
Radiation dermatitis is an inflammatory damage to the skin and mucous membranes caused by radiation (mainly beta and gamma rays and X-rays). The disease is mainly seen in patients receiving radiation therapy and those who are not well protected in radiation work. Can cause a series of skin reactions and injuries, manifested as reversible hair loss, dermatitis, pigmentation and irreversible skin atrophy, destruction of sebaceous glands, sweat glands and permanent hair loss, resulting in radiation necrosis, followed by the formation of ulcers.
- nickname
- Skin radiation damage
- English name
- radiodermatitis
- Visiting department
- dermatology
- Multiple groups
- Patients receiving radiation therapy and those who are not well protected in radiation work
- Common locations
- skin
- Common causes
- ionizing radiation
- Common symptoms
- Reversible hair loss, dermatitis, pigmentation, and irreversible skin atrophy, destruction of sebaceous and sweat glands, and permanent hair loss, etc.
Basic Information
Causes of radiation dermatitis
- Various types of ionizing radiation can cause the skin to respond to varying degrees. The basic lesions of biological tissue damage are consistent, that is, the DNA in the nucleus absorbs radiant energy, resulting in reversible or irreversible DNA synthesis and cell differentiation. Effect, resulting in changes in cell genetic information. A series of skin reactions and injuries are caused by these basic lesions, and the effects of small doses of radiation on the skin are hidden and accumulated. The sooner or later the damage occurs is related to the nature of the radioactivity, the dose and the individual differences of the patients.
Clinical manifestations of radiation dermatitis
- Acute radiation dermatitis
- Caused by one or more large doses of radiation, but sensitive people can develop disease even if the dose is not large. The incubation period varies from 8 to 20 days depending on the dose of radiation and the tolerance of each person. Can be divided into three degrees:
- (1) Degree is bright red in the beginning, dark red spots later, or mild edema. Conscious burning and itching. Desquamation and pigmentation occurred after 3 to 6 weeks.
- (2) Degree II Significant acute inflammation, edema, erythema, tense and shiny surface, blister formation, and erosion surface after blister break. Conscious burning or pain. Healed after 1 to 3 months, leaving pigmentation, loss of pigment, dilation of capillaries and skin atrophy.
- (3) Grade III erythematous edema quickly causes tissue necrosis, and later forms refractory ulcers. The depth of the ulcer is variable, and can generally penetrate the skin and muscles, and even bone tissue. There is a contaminated yellow-white necrotic tissue block on the underside of the ulcer. Conscious pain. It is difficult to heal, and atrophic scars, hyperpigmentation, depigmentation, and capillary dilatation are formed after healing. In severe cases, large blood vessels were occluded, and dry gangrene occurred in the limbs. Cancer can be secondary to ulcers and scars.
- Degrees and can be accompanied by systemic symptoms, such as headache, dizziness, malaise, loss of appetite, nausea, vomiting, abdominal pain, diarrhea, bleeding, and decreased white blood cell count. Serious cases can be life threatening.
- 2. Chronic radiation dermatitis
- Most are caused by long-term, repeated low-dose radiation, or are transformed from acute radiation dermatitis. The incubation period is from months to decades. Inflammation is not significant. Due to radiation damage to the sebaceous glands, sweat glands, hair follicles, and germinal cells of the nail bed, the skin is dry, rough, cracked, hair is shed, and the nail color is dull, and mediastinal, pigmented, thickened, and even shed. Nail crinkle microcirculation changes, abnormal tuberculosis and capillary blood viscosity.
Radiation Dermatitis Diagnosis
- According to the patient's history of radiation exposure, the damage occurred at the radiation site and clinical characteristics similar to thermal burns, making it easy to diagnose. Pathological examination helps diagnosis.
Radiation Dermatitis Treatment
- General treatment
- Once the disease occurs, the radiation should be stopped in time, and protection should be avoided to avoid external stimuli.
- Local treatment
- (1) Calamine lotion can be used when acute radiation dermatitis and degree erythema edema is obvious. For acute dermatitis and chronic dermatitis without edema, mild non-irritating creams and ointments can be used, such as vitamin E cream, 10% cod liver oil ointment and other skin creams. Corticosteroid creams or ointments can also be used.
- (2) For ulcerative lesions, antibiotic ointments such as mupirocin can be used, or 10% cod liver oil ointment or helium-neon laser irradiation can be used. For refractory ulcers, surgical resection and skin grafting can be considered.
- (3) For precancerous or early cancerous damage, 5% 5-fluorouracil ointment or surgical resection can be used.
- 3. Systemic treatment
- Mainly to strengthen supportive therapy, give high protein, high vitamin diet, if necessary, infusion, energy mixture and amino acids, etc., and supplement vitamins A, D, B, C, E and so on. Other salvia miltiorrhiza tablets and low molecular dextran can be used to improve local or systemic microcirculation.
Radiation Dermatitis Prevention
- To prevent the occurrence of this disease:
- 1. Avoid excessive doses during radiotherapy.
- 2. Observe the skin changes in detail after radiotherapy. If dermatitis has occurred, stop taking photos and follow up regularly.
- 3. The personnel engaged in radiation work shall strictly abide by the operating regulations and strengthen the protective measures.
- 4. Periodic physical examination, those who are found to have lesions should take a break in time, and those who are more serious should consider changing jobs. If it is found that there are vegetations on the hands of those who are engaged in X-ray work, they should be closely followed to prevent cancer.