Normal Skin No visible skin change.
“Radiation therapy causes biochemical changes within cells, as the DNA molecules are susceptible to radiation damage during mitosis. Radiobiological damage affects regeneration of the skin by the process of repair, redistribution, repopulation and reoxygenation. Damaged cells are replaced by cells moving from the resting phase into the active cycle (repopulation).”15 |
Dull erythema A faint or dull redness (erythema) occurs. A mild tightness of the skin and itching may occur.
“Skin damage occurs when the rate of repopulation of the basal cell layer (Stratum Germinativum) cannot match the rate of cell destruction by treatment. The inflammatory response activated is a normal physiological reaction to radiotherapy. Radiotherapy induced skin damage is seen approximately 10-14 days following the first fraction of radiation.”15 |
Picture: Courtesy of The Princess Royal Radiotherapy Review Team, St James’s Institute of Oncology | Patchy moist desquamation Dry desquamation starts to be moist with yellow/pale green exudate. Soreness with oedema is visible. |
Picture: Courtesy of The Princess Royal Radiotherapy Review Team, St James’s Institute of Oncology. | Confluent moist desquamation What was patchy dry desquamation turns into a confluent moist desquamation. The color of the wound fluid (exudate) is still yellow/pale green. Sore feeling.
“As radiation therapy continues, the basal layer cannot produce enough new cells to replace the old ones and therefore the outer layer of the epidermis will break, oedematous with exudate (moist desquamation). The exudate is normal and rich in nutrients which helps the growth of new skin cells.”15 |
Ulceration and bleeding Ulceration, bleeding, necrosis (rare).
Further progressing moist desquamation can lead to ulcerations and bleeding. “Skin necrosis is rarely seen primarily due to the advanced techniques used in the delivery of radiotherapy.”15 |
Dry desquamation and erythema A bright redness (erythema)/ dry desquamation occurs. The skin feels sore, itchy and tight.
“As the skin is damaged through further exposure to radiation it tries to compensate by increasing mitotic activity in order to replace the damaged cells. However, if the new cells reproduce faster than the old cells are shed then the skin will become dry and flaky (dry desquamation).”15 |
Normal Skin No visible skin change.
“Radiation therapy causes biochemical changes within cells, as the DNA molecules are susceptible to radiation damage during mitosis. Radiobiological damage affects regeneration of the skin by the process of repair, redistribution, repopulation and reoxygenation. Damaged cells are replaced by cells moving from the resting phase into the active cycle (repopulation).”15 |