Radiodermitis tras procedimientos diagnósticos-terapéuticos guiados por fluoroscopia

Freixas, Patricia Bassas; Soler, Ramón Bartralot; Español, Gloria Aparicio; Briones, Vicente García-Patos

doi:10.1157/13110224

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…The total radiation dose is the most important causal factor. 1 The diagnosis is primarily clinical and should be considered in any patient with a history of procedures using fluoroscopy who develops well-defined skin lesions; however, biopsy is essential to rule out malignant disease. 2 For radiation dermatitis without ulceration, topical treatments can be effective.…”

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confidence: 99%

Radiation dermatitis in a patient treated for hepatocarcinoma

Velasco-Amador¹,

Prados-Carmona²,

Ruíz‐Villaverde³

2023

CMAJ

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A 53-year-old man presented to our dermatology clinic with a painful, firm, well-defined indurated plaque (26 × 18 cm) on the mid-back, including a sclerodermiform and crusty central area (5 × 4 cm), which he had first noticed 8 months previously (Figure 1A). Ten months before presentation, he received a diagnosis of hepato car cinoma, which was treated with arterial chemoembol ization, requiring multiple prolonged fluoroscopy sessions. Based on his history and presentation, we suspected radiation dermatitis; differential diagnoses included squamous cell carcinoma, morphea and panniculitic lymph oma. We biopsied the lesion, and pathological analysis showed dermal sclerosis, red blood cell extravasation with hemosiderin pigment and reactive endothelium without vasculitis. The history of radiation exposure, clinical presentation and histology confirmed the diagnosis of radiation dermatitis.An ulcer developed in the centre of the lesion 2 months after presentation. Despite starting treatment with topical betamethasone and mupirocin, and negative pressure dressings, the lesion progressed in size (Figure 1B). The patient had resection and reconstruction with a myocutaneous flap (Figure 1C). Further histo pathology confirmed the previous biopsy findings.Radiation dermatitis is classified as either acute (in the first 90 days after radiation) or chronic (months to years after radiation). The total radiation dose is the most important causal factor. 1 The diagnosis is primarily clinical and should be considered in any patient with a history of procedures using fluoroscopy who develops well-defined skin lesions; however, biopsy is essential to rule out malignant disease. 2 For radiation dermatitis without ulceration, topical treatments can be effective. Once an ulcer appears, reconstructive surgery is usually ne cessary to allow wound healing. Case reports show no difference in reconstructive outcomes with fasciocutaneous flaps compared with full-thickness skin grafts. Resolution depends on adequate resection of the damaged areas beyond the sclerotic plaque. 3

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confidence: 99%

Radiation dermatitis in a patient treated for hepatocarcinoma

Velasco-Amador¹,

Prados-Carmona²,

Ruíz‐Villaverde³

2023

CMAJ

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“…La dermatite radique est classée selon qu’elle est aiguë (au cours des 90 jours suivant la radiation) ou chronique (de quelques mois à des années suivant la radiation). La dose totale de radiation est le plus important facteur causal 1 . Le diagnostic repose avant tout sur les signes cliniques et devrait être envisagé dès qu’il y a des antécédents d’interventions par fluoroscopie à l’origine de lésions cutanées bien délimitées; toutefois, la biopsie est essentielle pour écarter tout diagnostic de néoplasie 2 .…”

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Dermatite radique associée au traitement de l’hépatocarcinome

Velasco-Amador¹,

Prados-Carmona²,

Ruíz‐Villaverde³

2023

CMAJ

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Chronic Scalp Ulceration as a Late Complication of Fluoroscopically Guided Cerebral Aneurysm Embolization

2012

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Fluoroscopy-induced chronic radiation dermatitis resulting from prolonged exposure to ionizing radiation during interventional procedures has been documented in the medical literature. However, this condition often requires a high clinical suspicion in order to establish a correct diagnosis. In this report, the development of deep scalp ulceration with bone exposure following the endovascular coiling of an anterior communicating artery aneurysm 8 years before is described. A skin biopsy specimen demonstrated changes consistent with chronic radiation dermatitis and ruled out malignancy. This case report expands the clinical manifestation spectrum of fluoroscopy-induced chronic radiation skin injury and highlights the importance of recognizing these lesions early to prevent morbidity related to radiation-induced skin damage.

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Radiodermitis tras procedimientos diagnósticos-terapéuticos guiados por fluoroscopia

Cited by 4 publications

References 3 publications

Radiation dermatitis in a patient treated for hepatocarcinoma

Radiation dermatitis in a patient treated for hepatocarcinoma

Dermatite radique associée au traitement de l’hépatocarcinome

Chronic Scalp Ulceration as a Late Complication of Fluoroscopically Guided Cerebral Aneurysm Embolization

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