Cryosurgical treatment of professional chronic radiodermatitis. 1997

J S Conejo-Mir, and J C Moreno, and F Camacho
Department of Medical Surgical Dermatology and Venereology, University School of Medicine of Seville, Spain.

BACKGROUND Chronic x-ray dermatitis in professionals is a frequent problem for doctors in our country due to the fact that many of them widely used radiotherapy without any protection 15-20 years ago. Surgery has been the most accepted treatment, though it generally decreases hand function. OBJECTIVE Up to now, cryosurgery was not usually considered as a possible treatment if the lesions were located on fingers. In this study, the advantages of cryosurgery for the treatment of professional chronic radiodermatitis with incipient pretumoral lesions are emphasized. METHODS Cryosurgery was performed on six patients affected with chronic professional radiodermatitis that showed keratomas and ulcerations, using both spray (keratomas) and a probe 0.5 cm in diameter (ulcerations, in situ squamous cell carcinoma). Nerve block anesthesia with mepivacaine 1% was used in all cases. Before the treatment, all suspected lesions were biopsied; if invasive squamous cell carcinoma was revealed in the dermatopathological study, the patient was rejected. Variables such as blister and necrosis formation, pain, and achromatic, sensibility, and mobility disorders were studied. The follow-up period was 2 years. RESULTS Immediate postoperative results showed great pain and blistering in all cases. Residual achromias were observed early postoperatively in all cases, but were repigmented 1 year after therapy in four cases (66%). Sensory alterations (hypo- and hyperthesias) were found in four cases (66%) 1 month after treatment, although this complication was not observed 6 months after treatment. Finger mobility was perfect in all cases 2 months after treatment, and there was no recurrence in any case after 2 years of follow-up. CONCLUSIONS We believe cryosurgery must be considered as an excellent treatment for professional chronic radiodermatitis with keratomas, ulcerations, and incipient squamous cell carcinomas. Its use may prevent further dramatic surgical treatment, like amputations, allowing the preservation of finger function.

UI MeSH Term Description Entries
D007642 Keratosis Any horny growth such as a wart or callus. Keratoderma Blennorrhagicum,Keratoma,Keratosis Blennorrhagica,Blennorrhagica, Keratosis,Blennorrhagicas, Keratosis,Blennorrhagicum, Keratoderma,Blennorrhagicums, Keratoderma,Keratoderma Blennorrhagicums,Keratomas,Keratoses,Keratosis Blennorrhagicas
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011832 Radiation Injuries Harmful effects of non-experimental exposure to ionizing or non-ionizing radiation in VERTEBRATES. Radiation Sickness,Radiation Syndrome,Injuries, Radiation,Injury, Radiation,Radiation Injury,Radiation Sicknesses,Radiation Syndromes,Sickness, Radiation,Sicknesses, Radiation,Syndrome, Radiation,Syndromes, Radiation
D011855 Radiodermatitis A cutaneous inflammatory reaction occurring as a result of exposure to ionizing radiation. Dermatitis, Radiation-Induced,Radiation Recall Dermatitis,Radiation-Induced Dermatitis,Radiation Recall Reaction,Dermatitides, Radiation Recall,Dermatitides, Radiation-Induced,Dermatitis, Radiation Induced,Dermatitis, Radiation Recall,Radiation Induced Dermatitis,Radiation Recall Dermatitides,Radiation Recall Reactions,Radiation-Induced Dermatitides,Radiodermatitides,Reaction, Radiation Recall,Reactions, Radiation Recall,Recall Reaction, Radiation,Recall Reactions, Radiation
D002294 Carcinoma, Squamous Cell A carcinoma derived from stratified SQUAMOUS EPITHELIAL CELLS. It may also occur in sites where glandular or columnar epithelium is normally present. (From Stedman, 25th ed) Carcinoma, Epidermoid,Carcinoma, Planocellular,Carcinoma, Squamous,Squamous Cell Carcinoma,Carcinomas, Epidermoid,Carcinomas, Planocellular,Carcinomas, Squamous,Carcinomas, Squamous Cell,Epidermoid Carcinoma,Epidermoid Carcinomas,Planocellular Carcinoma,Planocellular Carcinomas,Squamous Carcinoma,Squamous Carcinomas,Squamous Cell Carcinomas
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D003452 Cryosurgery The use of freezing as a special surgical technique to destroy or excise tissue. Cryoablation,Cryoablations,Cryosurgeries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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