Frequency of cutaneous manifestations of radiotherapy
Keywords:
Radiation therapy, radiodermatitis, moist desquamation, dry desquamation, xerostomia, mucositis, pigmentationAbstract
Objective To determine different types of cutaneous manifestations secondary to ionizing radiation therapy in patients treated for various malignancies. Patients and methods The cross-sectional study was conducted on patients attending outpatient department of Dermatology and Oncology, Civil hospital Karachi, from 1st May 2006 till 31st August 2006. Patients belonging to both sexes and all age groups fulfilling the selection criteria were enrolled. After an informed consent, selected patients were subjected to a detailed history and clinical examination. A clinical diagnosis of different radiation-induced skin changes was made. Relevant investigations, biochemical profile and skin biopsy were done where required. All the findings were recorded, compiled, tabulated and analyzed. The type of radiation, dosage and duration of treatment was also recorded. Results 100 patients comprising 35 (35%) males and 65 (65%) females completed the study. Minimum age of presentation was 11 years and maximum 82 years, the mean age being 46.36 (SD 14.46). All the patients were receiving external beam therapy. Minimum radiation dose at which skin lesions appeared was 500cGy while maximum 7000cGy. Maximum number of patients developed cutaneous lesions in the dose range between 3100cGy to 6000cGy. Pigmentation (64%) was the most common cutaneous change followed by erythema (45%), epilation (42%), moist desquamation (26%) and oral mucositis (11%). Scalp alopecia, xerostomia, dry desquamation, ulceration, telangiectasia, atrophy and necrosis followed in a descending frequency. Amongst the enrolled subjects 31 patients (31%) were classified as suffering from acute radiodermatitis while another 11 as chronic radiodermatitis (11%). Conclusion Radiation therapy produces significant cutaneous manifestations on skin, pigmentary changes, erythema and epilation being the most common. Moist desquamation, oral mucositis, xerosis and scalp alopecia are seen less often. Severe changes which may lead to the interruption of therapy are seen less commonly.ÂReferences
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