Derm

Radiation Dermatitis

Radiation Dermatitis, Radiation Recall, Skin Reactions to Radiation Therapy, Radiation Therapy Induced Skin Changes

Comorbidities
1. Connective Tissue Disorders
2. Skin disorders
3. Body Mass Index >25 kg/m2
4. Smoking
Factors affecting severity
1. Total radiation dose
2. Dose fractionation schedule
3. Tissue volume treated
4. Moist Desquamation occurs more rapidly in previously irradiated regions
5. Concurrent Chemotherapy (Radiation Recall on re-initiation of Radiation Therapy)

Onset within hours to weeks of Radiation Therapy
Erythema
1. Pink, mildly swollen skin with Sensation of Pruritus or burning
Dry Desquamation
1. Epidermal basal cells partially sloughed
2. Skin dryness, pealing or Scaling
3. Hyperpigmentation
Moist Desquamation
1. Epidermal basal cells completely sloughed
2. Blisters
3. Serous discharge
4. Neuropathic pain

Gentle skin washing with Mild Soap and water
Skin Lubricant use regularly
Avoid exacerbating factors (e.g. hot baths, mechanical irritation)
Topical Corticosteroid (moderate to high potency, e.g. Betamethasone valerate, Mometasone furoate)
1. Indications (high risk for dermatitis)
  1. Breast Cancer
  2. Head and neck cancers
  3. Gynecologic cancers
  4. Anal or rectal cancer
  5. Large areas of Radiation Therapy
  6. High total doses of Radiation Therapy
2. Protocol
  1. Apply a thin layer of Topical Corticosteroid over intact skin twice daily
  2. Start at time of Radiation Therapy onset and continue for 2-3 weeks after treatment completed
Hydrofilm or Mepitel film
1. Indicated in Breast Cancer related Radiation Therapy
Photobiomodulation therapy
1. Indicated for Breast Cancer or head and neck cancer related Radiation Therapy