Acute radiodermatitis L58.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Acute X-ray dermatitis

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Acute dermatitis in the irradiated skin area, which occurs 6-12 days (but also later) after irradiation.

Clinical features
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The clinical symptoms are limited to the irradiation field and can be divided into 3 degrees.

  • Grade I: Erythematous stage with dark red erythema. Subsequently diffuse or spotty hyperpigmentation. Temporary blockage of sebaceous gland secretion. Hair loss 3 weeks after irradiation, hair regrowth 4-12 weeks after irradiation.
  • Grade II: Bullous stage with inflammatory redness, oedema, blistering, weeping. Irreversible loss of hair, sebaceous glands, nails and sweat glands.
  • Grade III: ulcerous stage with primary deep tissue necrosis, painful ulceration, acute x-ray ulcer, poor healing tendency.

General therapy
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Long-term control examinations (risk of carcinoma development).

External therapy
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Symptomatic therapy usually only after completion of the irradiation. If necessary, short-term interruption of the radiation therapy. For grade I, glucocorticoids such as 0.1% mometasone (e.g. Ecural fat cream), 0.25% prednicarbate (e.g. Dermatop cream) or 0.05% betamethasone Lotio R030, astringent powders such as tannin powder(Tannolact). In case of weeping changes and blister formation, moist compresses with antiseptic additives such as quinolinol (e.g. Chinosol 1:1000 or R042 ) or potassium permanganate (light pink). In the case of ulceration, wound treatment appropriate to the stage of ulceration.

Internal therapy
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Analgesic drugs such as acetylsalicylic acid (e.g. ASS) 3 times/day 500 mg, tramadol (e.g. Tramal Trp.) 20-40 Trp./day, ibuprofen (e.g. Ibuprofen Stada) 200-400 mg/day may be helpful.

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Cytostatic drugs can significantly increase the toxicity of radiotherapy applied a few days before. Radiatio recall is the term used to describe a dermatitis which manifests itself in a previously irradiated area within a few days to hours after initiation of a cytostatic drug therapy.

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  1. Prindaville B et al (2016) Radiation Recall Dermatitis Secondary to Dactinomycin. Pediatric Dermatol 33:e278-279.


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Last updated on: 29.10.2020