Fluoroscopy-induced Subacute Radiation Dermatitis in Patient with Hepatocellular Carcinoma

Bo Hye Kim; Hee Kyung Kim; Jae Kyung Shin; Hee Jin Hong; Joo Ho Lee; Hana Park; Seong Gyu Hwang; Kyu Sung Rim

doi:10.4166/kjg.2016.67.2.112

Journal List > Korean J Gastroenterol > v.67(2) > 1007476

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Kim, Kim, Shin, Hong, Lee, Park, Hwang, and Rim: Fluoroscopy-induced Subacute Radiation Dermatitis in Patient with Hepatocellular Carcinoma

Case Report

Korean J Gastroenterol 2016;67(2):112-115.

Published online: 4 October 2016

DOI: https://doi.org/10.4166/kjg.2016.67.2.112

Fluoroscopy-induced Subacute Radiation Dermatitis in Patient with Hepatocellular Carcinoma

Bo Hye Kim¹, Hee Kyung Kim¹, Jae Kyung Shin¹, Hee Jin Hong¹, Joo Ho Lee^1,², Hana Park^1,², Seong Gyu Hwang^1,², Kyu Sung Rim^1,²

¹Department of Internal Medicine, CHA University, Seongnam, Korea

²Division of Gastroenterology and Hepatology, Department of Internal Medicine, CHA Bundang Medical Center, Seongnam, Korea

Correspondence to: Joo Ho Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea. Tel: +82-31-780-5212, Fax: +82-31-780-5219, E-mail: piolee2000@naver.com

Received 18 August 2015 Revised 9 September 2015 Accepted 10 October 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Radiation dermatitis can develop after fluoroscopy-guided interventional procedures. Cases of fluoroscopy-induced radiation dermatitis have been reported since 1996, mostly documented in the fields of radiology, cardiology and dermatology. Since diagnosis and treatment of fluoroscopy-induced radiation dermatitis can be difficult, high grade of suspicion is required. The extent of this reaction is determined by radiation dose, duration of exposure, type of procedure, and host factors and can be aggravated by concomitant use of photosensitizers. Follow-up is important after long and complicated procedures and efforts to minimize radiation exposure time will be necessary to prevent radiation dermatitis. Herein, we report a case of a 58-year-old man with hepatocellular carcinoma presenting with subacute radiation dermatitis after prolonged fluoroscopic exposure during transarterial chemoembolization and chemoport insertion. Physicians should be aware that fluoroscopy is a potential cause of radiation dermatitis.

Keywords: Fluoroscopy, Radiation-induced dermatitis, Therapeutic chemoembolization, Hepatocellular carcinoma

References

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Fig. 1.

(A) One day after radiation therapy, the lesion is described as a relatively sharply demarcated, erythematous, square shaped patch with erosion and moist desquamation. (B) One month later, re-epithelialization is starting from the margin and a pinkish plaque is present. (C) Two month later, the entire lesion is almost healed and re-epithelialized.

Fig. 2.

Microscopic findings (H&E). (A) A dermal-epidermal separation and a mild inflammatory infiltrate involving the epidermis, papillary dermis, and vessels is seen (×40). (B) High-power field showed a atrophic change of the epidermis with scattered atypical keratinocytes, hyperkeratosis, and spongiosis (×100).

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