What is Chronic Radiation Dermatitis?
Chronic radiation dermatitis is a condition that affects the skin after being exposed to ionized radiation for several month or years. While there can be many causes, symptoms and treatments of chronic radiation dermatitis it is essential to diagnose the disease at early stage to ensure timely treatment.
Radiation dermatitis is a skin condition which occurs when a person is exposed to ionizing radiation from radiation therapy. Acute and chronic are the two types of radiation dermatitis. When the skin is exposed to radiation exposure for a very long time, chronic reaction occurs where the skin is damaged. This results in loss of sensation of skin. Chronic radiation dermatitis is an irreversible reaction, so only symptomatic treatment is possible. Skin grafting can also be done to restore the damaged skin, in severe cases.
Causes of Chronic Radiation Dermatitis
Chronic radiation dermatitis occurs due to radiation treatment for cancer and accidental occupational exposure. For people are suffering from HIV, connective tissue disorder and diabetes, the skin reaction can be worse. Anyone who is exposed to ionizing radiation for a very long period can be affected by chronic radiation dermatitis. It does not depend upon the age, race and gender.
Chronic radiation dermatitis is caused when the skin is exposed to ionizing radiation which can either be multiple high-level dose radiation or frequent low-level dose radiation. The disease can be caused when the person is undergoing a medical treatment for cancer or may be due to occupational exposure. The radiation is progressive and the skin condition is irreversible and can cause adverse damage to the skin cells. People who have sensitive skin can react very quickly to the radiation.
Risk Factors for Chronic Radiation Dermatitis
The risk factors for chronic radiation dermatitis may include:
- Radiation therapy for acne
- Psoriasis treatment
- Fungal infection of scalp in children
- Accidental occupational exposure
- Radiation therapy for treatment of cancer
- Radiation exposure during angiography or angioplasty procedure
- People who undergo chemotherapy for neck and head cancer
People who are suffering from the following diseases are at greater risk of chronic radiation dermatitis:
- Poorly-controlled diabetes
- Connective tissue disorders
- Systemic lupus erythematosus (SLE)
- HIV infection
- Genetic disorder such as xeroderma pigmentosa
- Basal cell nevus syndrome.
Signs and Symptoms of Chronic Radiation Dermatitis
The symptoms usually depend upon the condition of the disease. The symptoms of chronic radiation dermatitis usually vary and develop over a period of time when the skin is exposed to ionizing radiations. For few people with chronic radiation dermatitis, the symptoms and reaction can be seen at a very early stage, while for others it can be seen after years or may be even months.
Following are the signs and symptoms of chronic dermatitis when exposed to the radiation:
- Thick skin
- Loss of sensation
- Necrosis and ulceration on the skin
- Disappearance of skin pores.
- Skin becomes fragile.
- Nails turn thin and brittle
- Tiny hemorrhages under the skin due to damage to the capillaries.
- Inflamed and skin over the exposed area.
Diagnosis of Chronic Radiation Dermatitis
For diagnosis of chronic radiation dermatitis, a complete physical examination of the person must be done. A complete medical history and the details about previous and present treatments and nature of work need to be understood. The signs and symptoms of chronic radiation dermatitis can help in making a diagnosis. Additionally, investigations may be ordered, as appropriate. Diagnostic tests depending upon the associated condition (such as lupus, HIV infection, diabetes, etc) can be done if required.
Complications of Chronic Radiation Dermatitis
Chronic radiation dermatitis can lead to many complications. These include:
- Wound to the blisters can lead to bleeding and ulceration which leads to secondary infection.
- Skin is affected and people conscious about their appearance can face cosmetic issues.
- Being exposed to radiations for a longer duration can increase the risk of skin cancer such as basal cell carcinoma and squamous cell carcinoma.
- Any underlying disorder or conditions may lead to complications.
Treatment of Chronic Radiation Dermatitis
Chronic radiation dermatitis is generally a long term process and the condition of the skin is irreversible. If radiation therapy is going on, the treatment may have to be stopped or discontinued for a certain period so that the person can recover. Or else, the radiation dose can be reduced in therapy based on the severity of the condition and the need for the treatment.
Treatment of chronic radiation dermatitis mainly depends on the symptoms and complications. If there is minimal irritation and redness of skin it can be washed with soap to reduce itching and irritation. The bacterial infection can also be reduced if washed. Pain relieving and anti-infective creams can be used, as advised. Corticosteroid ointment is also prescribed by many doctors. If the skin lesions are a major cosmetic issue or if there are complications, skin grafting may be considered. People who are suffering from chronic radiation dermatitis must wear clothes which are loose and also avoid certain fabrics which can cause irritation to the skin.
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