Radiodermatitis chronic L58.1

Chronic X-ray damage to the skin that occurs after a latency period of months to years following exposure of the skin to ionizing radiation in the irradiation field. Chronic radiodermatitis has long been subsumed under the term: cutaneous radiation syndrome.

Radiation doses 12-15 Gy (1200-1500 Rd), after 2nd and 3rd degree radiodermatitis acuta or with repeated small radiation doses. Ionizing radiation generates reactive free radicals by breaking chemical bonds, which influence and change cellular structures such as lipids, peptides or DNA. The effect on the tissue is controlled by cytokine expression, including TGF-beta, interleukin-6, TNF-alpha, which probably begins immediately after irradiation and lasts for months. Activated fibroblasts play a decisive role in irreversible remodeling in the late phase - several months after irradiation.

Poikilodermatic, dry, atrophic skin, loss of skin appendages, patchy hyper- and/or depigmentation, telangiectasia. Later, trophic disorders with persistent ulcerations (chronic x-ray ulcer) may develop. In rare cases, morphea-like skin scleroses limited to the radiation field develop (see below Radiation-induced morphea)

After years of chronic radiodermatitis, X-ray keratoses are developing with a tendency to carcinoma development.

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