Radiation dermatitis

Description:

Radiation dermatitis (beam povrezhyodeniye of skin, x-ray or beam deryomatit) — damage of skin as a result of ionizing radiation.

Symptoms of Radiation dermatitis:

Early beam injuries of skin (early radiation or x-ray dermatitis). Early beam reactions or damages develop in the course of radiation of skin or in the first 3 months after influence. In this span there can be beam dermatitis (erythematic, dry, violent or wet). Erythematic dermatitis is characterized by an erythema, an insignificant bolezyonennost and an itch in the place of radiation. In the first weeks after beam influence появляют­ся a peeling, an unstable xanthopathy and a hair loss. Hair grow in 3-4 months. Dry dermatitis is shown razviyotiy a melkoplastinchaty peeling on obluyochenny sites of skin. Wet (violent) dermatitis is characterized by emergence of bubbles with serous or serous and purulent soderzhiyomy on erythematic edematous sites of skin. There are an expressed morbidity and an itch in the place of radiation. Bubbles burst and erosive surfaces which pokryyovatsya by a crust poyavlyayotsya. Healing under it proiskhoyodit within 2-3 months. After permission there are hems, hypo - or a hyperpegmentation, appendages of skin are lost and the atyorofiya of epidermis and a derma begins.
Late beam injuries of skin (pozdyony radiation or x-ray dermayotit). In the third period late luyochevy injuries of skin (an atrophy, ulcers, dobyorokachestvenny and malignant tumors) appear. Late beam damages can develop or as a result of a gradual narasyotaniye of pathological changes, or is more rare — sharply. In that and other case big znacheyony have accessory adverse factors: a close arrangement of a bone (a uveliyocheniye of an absorbed dose at the expense of scattered radiation at a roentgenotherapy), insolation, chemical irritation, operational vmeshayotelstvo, a purulent infection, vascular porayozheniye, diabetes, chemotherapy, etc. Late x-ray dermatitis harakyoterizutsya by a motley clinical picture: the centers hyper - and depigmentation, a skin atrophy with teleangiectasias and expanded poverkhyonostny venules, cicatricial changes, sites of a limited hyperkeratosis it is also long not healing ulcers. These kozhyony changes develop within 2-8 years after radiation. X-ray ulcers have an appearance of cracks on sites of a cicatricial atyorofiya in the beginning. Then they gradually increase in sizes, gaining irregular shape. Further they become covered by bloody or yellow crusts which hardly separate and extremely boleznenyona. Ulcers heal very slowly. Can have the big sizes. Beam ulcers arise in distal departments of the lower konechyonost more often. A clinical sign of a malignancy of a beam ulcer is regional consolidation in the form of the roller.

Reasons of Radiation dermatitis:

Radiation owing to which there are beam injuries of skin can be terayopevtichesky (treatment of malignant or benign tumors, ordinary eels, eczemas, etc.), emergency (accidental) or professional (at radiologists). Beam changes of skin cause rentgeyonovsky, electronic and at - radiations. Damages of an integument in most cases develop after radiation therapy malignant tumors. In medical practice for treatment of various diseases use a total exposure dose, as a rule, of 30-50 Gr and is more rare above. Divide luyochevy injuries of skin on early and late.

Treatment of Radiation dermatitis:

Treatment of early radiation dermatitis. At radiation therapy histamine level in blood in this connection at long carrying out radiation tselesoobyorazno with the preventive purpose to appoint antihistaminic drugs, vitamins E, B6 increases. With and Rutinum and also to carry out antioxidant therapy. Corticosteroid creams before reaction elimination are applied to treatment of erythematic and dry dermatitis. Further the cosmetic ointments containing vitamins A and E are used. At violent dermatitis carry out intensive proyotivovospalitelny and soothing treatment. For reduction of the inflammatory phenomena after processing of skin an antiseptic agent, the vskryyotiya of bubbles and removal of crusts are used lotions from 0,01% by Furacilin solution. Further corticosteroid ointments and the nutritious vitaminized creams or 10% metiluratsilovy ointment which accelerate epithelization are applied.
Treatment of late radiation dermatitis. Persons with not progressing maloyovyrazhenny atrophy of skin do not need active therapy. In these cases tselesoobrazyono to respect the hygienic rules, to isklyuyochat contacts with provocative agents (insolation, drugs of household chemicals), при­менять nutritious creams with vitamins. At the expressed symptoms of late rentgenovsyoky dermatitis use the general and local medical actions. For the purpose of stimulation of regenerative processes appoint a full-fledged diet. It has to be caloric (2600-3000 kcal), with a high share of protein, to soderyozhat food carriers of ascorbic acid, vitamins of group B, Retinolum, salts of zinc, manganese, copper which positively influence oxidizing processes and protein metabolism. Content of table salt and fats ograyonichivatsya. Carry out treatment of associated diseases, appoint drugs, uvelichivayuyoshchy resistance of an organism, plastic processes in an ulcer, an antimicrobic himioyoterapiya, an immunotherapy, hemotransfusion and blood substitutes, vasodilating, leyochebny physical culture and sometimes physical therapy. Apply solkoserit intramusculary 2 ml 2 times a day (a course of treatment — 4-6 weeks), ex-terrorist attack of an aloe liquid subcutaneously on 2 ml daily or every other day (30 injections), 6% solution of a vitayomin In, intramusculary (5 injections), Aevitum on 1 capsule 2 times pass (20-25 days), Xantinoli nicotinas on 0,15-0,3 g 3 times a day after food with gradual decrease. The course of treatment is povyotoryat in 1,5-2 months. Local a meroyopriyatiya include purpose of the outside protiyovovospalitelny and epithelizing means (Shostakovsky's balm, corticosteroid creams with disinfecting additives, ointments with methyluracil, Actovegin or solkoseri-scrap, etc.). Giperkeratoza and warty razyorastaniye delete by means of a cryolysis or 5% of 5-ftoruratsilovy, 30% prospidinovy ointments. In certain cases in the presence of an ulcer carry out its excision with the subsequent skin plastics.