Beam dermatitis
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Description:
Beam dermatitis (x-ray dermatitis) are the inflammatory changes resulting from impact of ionizing radiation in skin. Clinical displays of beam dermatitis depend on an exposure dose. In the acute period reddening, emergence of bubbles and formation of badly healing ulcers is possible. In later period there is a dryness and atrophic changes, the carcinoma cutaneum can develop. The characteristic clinical picture and accurate communication of developing of a disease with ionizing radiation usually does not raise doubts in diagnosis.
Symptoms of Beam dermatitis:
Injuries of skin by ionizing radiation divide on early and late. Early are shown during radiation or within 3 months after it. Late injuries of skin can develop years later after beam influence. Between early and late damages there is an intermediate period duration from several months to many years.
Acute beam dermatitis belongs to early injuries of skin. At an exposure dose of 8-12 Gr there is an erythematic form of acute beam dermatitis. It is characterized by erubescence on the site of radiation, emergence of an itch and morbidity. The peeling and a hair loss is noted. In 3-4 months growth of hair is recovered. The erythematic form is considered admissible reaction of skin to radiation as it does not lead to emergence of late complications.
Radiation of skin in a dose of 12-20 Gr leads to development of a violent form of beam dermatitis. It arises against the background of reddening, an itch, morbidity, puffiness of skin and is characterized by emergence of serous bubbles. When bubbles are opened, on their place erosion which become covered by crusts are formed and heal within 2-3 months. Violent beam dermatitis is followed by increase in regional lymph nodes, fervescence and a hair loss.
At an exposure dose more than 25 Gr the necrotic form of beam dermatitis develops. It is followed by the expressed pains, high temperature, weakness, sleeplessness. Weight of a condition of the patient depends on the area of an affected area of skin. Skin manifestations take place from a stage of reddening and bubbles before education is long not healing ulcers. And ulcers can arise bypassing a violent stage.
Chronic beam dermatitis can be a consequence of acute or develops initially as a result of repeated impact on skin of small doses of ionizing radiation. Its emergence is promoted by the increased insolation, a diabetes mellitus, impact on skin of chemical irritants, vascular pathology, a purulent infection, etc. Treat displays of chronic beam dermatitis: a xeroderma, formation of cracks, a hyperkeratosis, sites hypo - and hyperpegmentations, atrophic beam ulcers.
Reasons of Beam dermatitis:
Presently beam dermatitis can arise in connection with professional activity (at radiologists) and at emergencies. It can also be therapeutic, that is developed as a result of radiation therapy which is applied in treatment of malignant tumors and some diseases of skin.
Treatment of Beam dermatitis:
Treatment of an erythematic form of beam dermatitis is carried out by corticosteroid creams. At violent and necrotic forms stopping of a pain syndrome and antiinflammatory therapy is shown. Bubbles open or suck away their contents. Apply corticosteroid ointments and 10% to improvement of healing of erosion and ulcers metiluratsilovy ointment. The necrotic form of dermatitis often demands surgical excision of the nekrotizirovanny site.
Chronic beam dermatitis with not expressed skin atrophy does not need active treatment. The exception of the irritating factors and use of nutritious creams is necessary. At the expressed symptomatology appoint the antiinflammatory and epithelizing means (corticosteroid ointments, solkoserit, Actovegin, etc.). At education it is long not healing beam ulcer its excision is shown.
