Fluoroscopy-Induced Chronic Radiation Dermatitis

Spiker, Alison; Zinn, Zachary; Carter, William H.; Powers, Roxann; Kovach, Rodney

doi:10.1016/j.amjcard.2012.08.023

Cited by 28 publications

(19 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although interventional procedures provide enormous advantages over invasive surgical procedures, long periods of radiation exposure may increase the risk of deterministic effects in patients, thus causing radiation-induced skin injuries. [2][3][4][5][6][7] The US Food and Drug Administration (FDA), 8 the World Health Organization (WHO), 9 the International Commission on Radiological Protection (ICRP), 10 and the International Atomic Energy Agency (IAEA) 11 have all expressed concerns regarding patient skin dose. They have also issued guidance on the prevention of skin injuries in high dose interventional procedures.…”

Section: Introductionmentioning

confidence: 99%

Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

Safari

Wong

et al. 2015

Medical Physics

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

Safari

Wong

et al. 2015

Medical Physics

View full text Add to dashboard Cite

show abstract

“…Chronic radiation dermatitis occurs months to years after exposure and typically features permanent erythema and telangiectasias, skin fragility, ulceration, loss of follicular structures, late-onset dermal necrosis, and secondary cutaneous malignancies. 1 , 2 , 5 Histologically confirmed radiation dermatitis reveals ulceration, prominent telangiectasias, atypical stellate fibroblasts, epidermal atrophy, and absence of inflammation. 1 …”

Section: Discussionmentioning

confidence: 93%

“… 7 Common sites of FICRD correspond to the sites of ionizing radiation beam entry during fluoroscopic procedures and include the axilla, scapula, and mid aspect of the back. 1 , 5 …”

Section: Discussionmentioning

confidence: 99%

Fluoroscopy-induced chronic radiation dermatitis (FICRD) after endovascular abdominal aortic aneurysm endoleak repair

2015

View full text Add to dashboard Cite

“…The histological features of these lesions include epidermal atrophy, dermal sclerosis (eosinophilic homogenized sclerosis of dermal collagen), dilated superficial blood vessels, loss of adnexal structures (hair follicle and sweat duct), and increased atypical stellate-shaped fibroblasts. 11 , 12 In most situations, the proper diagnosis of radiation skin damage can be made by combining the clinical presentations and a radiation exposure history. Skin biopsy should be reserved when histology pictures are needed for a correct diagnosis such as radiation malignancy or invasive deep infections are suspected.…”

Section: Discussionmentioning

confidence: 99%

STROBE—Radiation Ulcer

et al. 2015

View full text Add to dashboard Cite

With increasing numbers of percutaneous coronary intervention (PCI) and complex cardiac procedures, higher accumulated radiation dose in patient has been observed. We speculate cardiac catheter intervention induced radiation skin damage is no longer rare.To study the incidence of cardiac fluoroscopic intervention induced radiation ulcer.We retrospectively reviewed medical records of those who received cardiac fluoroscopic intervention in our hospital during 2012 to 2013 for any events of radiation ulcer. Only patients, whose clinical photos were available for reviewing, would be included for further evaluation. The diagnosis of radiation ulcers were made when there is a history of PCI with pictures proven skin ulcers, which presented typical characteristics of radiation injury.Nine patients with radiation ulcer were identified and the incidence was 0.34% (9/2570) per practice and 0.42% (9/2124) per patient. Prolonged procedure time, cumulative multiple procedures, right coronary artery occlusion with chronic total occlusion, obesity, and diabetes are frequent characteristics. The onset interval between the first skin manifestation and the latest radiation exposure varied from 3 weeks to 3 months. The histopathology studies failed to make diagnosis correctly in 5 out of 6 patients. To make thing worse, skin biopsy exacerbated the preexisting radiation dermatitis. Notably, all radiation ulcers were refractory to conventional wound care. Surgical intervention was necessary to heal the wound.Diagnosis of cardiac fluoroscopy intervention induced radiation skin damage is challenging and needs high index of clinical suspicion. Minimizing the radiation exposure by using new approaches is the most important way to prevent this complication. Patient education and a routine postprocedure dermatology follow up are mandatory in high-risk groups for both radiation skin damage and malignancies.This is a retrospective study, thus the true incidence of radiation ulcer caused by cardiac fluoroscopic intervention could be higher.

show abstract

Fluoroscopy-Induced Chronic Radiation Dermatitis

Cited by 28 publications

References 14 publications

Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

Fluoroscopy-induced chronic radiation dermatitis (FICRD) after endovascular abdominal aortic aneurysm endoleak repair

STROBE—Radiation Ulcer

Contact Info

Product

Resources

About