Cosmetic management of the sequelae of thorium X radiotherapy for naevus flammeus

Abstract

Background: Naevus flammeus is a benign cutaneous angioma that often appears on the face, causing cosmetic concern. Early this century, radiotherapy was frequently employed to try to remove the lesion. Thorium X, an alcohol-based paint, was a favoured radiotherapeutic agent. Unfortunately, thorium X therapy has side effects, including carcinogenesis. I present a case of a 62-year-old woman who suffered both gross neoplastic dermal disease and the full gamut of ophthalmic radiation-related disease after thorium X radiotherapy for naevus flammeus. The management of this patient included extensive plastic surgery and the fitting of a prosthetic contact lens. Discussion: The history of radiotherapy for naevus flammeus and other angiomata sends a striking message about the risk of long-term sequelae of new treatments. Current treatment for naevus flammeus is also controversial. This case demonstrates the ocular and dermal sequelae of radiation injury and their management, including detailed consideration of the process of fitting a prosthetic contact lens. The outcome of this process has been dramatic improvement in the patient's self-confidence and quality of life.