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 dermato‐pathological 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 presentation of finger function.
[1]
Graham Gf.
Advances in cryosurgery during the past decade.
,
1993
.
[2]
M. de la Brassinne,et al.
Subungual chronic radiodermatitis.
,
1993,
Dermatology.
[3]
T. Rosen,et al.
Acute radiodermatitis from occupational exposure to iridium 192.
,
1989,
Southern medical journal.
[4]
P. Holt,et al.
Cryotherapy for skin cancer: results over a 5‐year period using liquid nitrogen spray cryosurgery
,
1988,
The British journal of dermatology.
[5]
B. Naafs,et al.
Sensory loss following cryosurgery of skin lesions
,
1987,
The British journal of dermatology.
[6]
S. Inoue,et al.
Radiodermatitis--an analysis of 43 cases.
,
1986,
The Journal of dermatology.
[7]
E. G. Kuflik,et al.
Effects of systemic corticosteroids on post-cryosurgical edema and other manifestations of the inflammatory response.
,
1985,
The Journal of dermatologic surgery and oncology.
[8]
G. Mikhail.
Subungual epidermoid carcinoma.
,
1984,
Journal of the American Academy of Dermatology.
[9]
R. Coskey,et al.
Bowen's disease of the nail bed.
,
1972,
Archives of dermatology.
[10]
R. Spiro,et al.
Radiation‐induced skin cancer of the head and neck
,
1970,
Cancer.
[11]
F. Lagrot.
[What can be expected from surgery in the treatment of professional radiodermatitis of the fingers? (Results of 74 cases)].
,
1966,
La Presse medicale.
[12]
E. Epstein.
DERMATOLOGIC RADIOTHERAPY 1965.
,
1965,
Archives of dermatology.
[13]
K. Pickrell,et al.
RADIATION DERMATITIS AND RADIOGENIC NEOPLASMS OF THE HANDS.
,
1964,
Annals of surgery.
[14]
N. Anderson,et al.
Development of basal cell epithelioma as a consequence of radiodermatitis.
,
1951,
A M A Archives of Dermatology and Syphilology.