ACUTE RADIODERMATITIS FROM ACCIDENTAL OVEREXPOSURE TO X-RAYS

Approximately 2 weeks after accidental overexposure to X-ray radiation , a worker developed acute radiodermatitis on fingers of both hands. E xposure simulation indicated that total ionizing radiation absorbed by his fingers amounted to about 20 Gy. After 2 years, acute radiodermat itis evolved to chronicity of lesions with presence of atrophic skin, teleangiectasia, alopecia, and dyskeratosis on three right-hand finger s. Cytogenetic dosimetry of peripheral blood lymphocytes, performed 2 months after acute radiation, showed an increase of micronuclei (7% vs . 1 +/- 0.4% according to laboratory reference data). The increase was ascribed to the high dose of ionizing radiation absorbed by circulati ng lymphocytes in the vessels of overexposed tissues. The cytogenetic examination was repeated 27 months after acute irradiation; it was fou nd that the percentage of micronuclei had been restored to within refe rence levels. The possibility of using cytogenetic dosimetry, followin g acute partial exposure to X-rays, not just as an indicator of previo us exposure, but also as an indicator of the absorbed radiation dose i s examined. Lastly, the possible stochastic effects that may set in on the skirt of the affected fingers and the need for periodically monit oring the evolution of chronic skin lesions, are discussed. (C) 1996 W iley-Liss, Inc.