Cutaneous radiation syndrome: clinical features, diagnostic criteria and therapy

Accidental exposure to ionizing radiation may occur during such catastrophi c events as the Chernobyl accident in 1986 or over days to weeks as in Goia nia in 1987 and in the military camp during the training of soldiers in Lil o/Georgia in 1997, as well as in medical institutions. The cutaneous sympto ms after radiation exposure are based on a combination of inflammatory proc esses and alteration of cellular proliferation as a result of a specific pa ttern of transcription ally activated proinflammatory cytokines and growth factors. They follow a time course consisting of prodromal erythema, latenc y period, acute stage, chronic stage and late stage. The entire complex is referred to as cutaneous radiation syndrome. The time course depends on sev eral factors such as the radiation dose, radiation quality, individual radi ation sensitivity, the extent of contamination and absorption and amount of skin exposed. For the diagnosis of the cutaneous radiation syndrome the fo llowing procedures are used: 7.5 MHz to 20 MHz-B-scan sonography, thermogra phy, capillary microscopy, profilometry, nuclear magnetic resonance imaging , bone scintigraphy and histology. Based on the results of experimental and clinical research, today treatment may include topical or systemic cortico steroids, gamma-interferon, pentoxifylline, vitamin E and superoxide dismut ase. The treatment depends on the stage of the cutaneous radiation syndrome . Due to the complexity of the clinical manifestations of radiation disease , most patients require interdisciplinary treatment in specialized centres. Dermatologists are essential partners in the life-long follow-up and thera py of such patients.