Radiation-Induced Dermatitis

Radiation-induced dermatitis is a common side effect of radiation therapy in cancer patients in whom the skin is exposed to the radiation source. Acute dermatitis is most commonly observed in patients with cutaneous neoplasms, head and neck cancer or breast cancer.  Dermatitis typically develops during the second to third week of fractionated radiation. The condition is often unpleasant, painful and may contribute to poor quality of life in cancer patients. In some cases, radiation dermatitis may become so severe as to necessitate interruption or cessation of radiation therapy. All cancer patients receiving radiation therapy are at risk for skin damage. However, incidence of radiation dermatitis varies by cancer type and radiation therapy regimen. It is estimated that 5-10% of patients treated with radiation therapy for breast cancer will develop moderate to severe radiation-induced dermatitis.

Radiation dermatitis usually begins with reddening of the skin, but may also include the epilation, dry desquamation, wet desquamation, decreased sweating, edema, ulceration and bleeding. Areas of telangiectasia, hyper- and hypo-pigmentation are also common. Symptom progression depends on both treatment-related factors, such as the total radiation dose, fractionation, total duration of treatment, volume of tissue irradiated, and type of radiation delivered; as well as patient-related factors such as age, menopausal state, and pre-disposing genetic factors. Most treatment for dermatitis is palliative, with moisturizing creams such as Aquaphor, or corticosteroids.

Statistical analysis of the duration and severity based on these scores is used to evaluate the efficacy of novel treatment regimens.

Normal Skin

Radiation Dermatitis