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“BETA RADIATION SKIN LESION
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types. The difference in pigment in the region
of the basal layer has been noted, The superficial
corium shows relatively uniform papillae, There
is moderate vascularity with no apparent changes
within the vessel walls. There are relatively frequent groups of mononuclear cells present in the
subcutaneous area, often in relation to the small
vessels, but with no appreciable difference in distribution throughout the subcutaneous area. There
Sg ma apts.
are,
in
the
superficial
corium
regularly
spaced
areas of basophilic hyaline and granular degeneration of the collagenous and elastic tissue. These
are well circumscribed and appear with regularity
in the superficial corium beneath both pigmented
and nonpigmented areas. There are large numbers
of sebaceous gland structures through the subcutaneous tissue placed with regularity in association
with hair structures. No abnormalities of these
sebaceous glands or of the sweat structures are
noted. The surrounding connective tissue varies
in density, appearing less dense in the superficial
areas. A few areas (center of Fig. 3) show the
irregular pattern of connective tissue with large
fibroblasts suggestive of radiation effect.
The collagen and elastic tissue was examined in
relation to vertical distribution through the entire
subcutaneous area beneath the pigmented and nonpigmented areas. The deepest portions of the subcutaneous tissues beneath pigmented and nonpigmented skin showed completely similar appearance
of the collagen and elastica, the latter appearing
as sharply staining and well-defined strands of
elastica (Gomori aldehyde fuchsin stain for elas-
tica). The intermediate areas of the subcutaneous
tissue displayed, however, some differences in the
distribution and staining of the elastic tissue.
Figures 4, 5, and 6 represent areas of the intermediate (in depth) subcutaneous tissue, each photomicrograph taken at exactly the same distance
beneath the skin surface, orientation as indicated
in Figure 2. The elastica beneath the pigmented
area is sharply outlined and normal in appearance.
The elastica beneath the nonpigmented area is
the lesion developed several weeks after
handling and spillage of radioactive materials.
In addition, this officer has had a
long-standing habit of massaging the right
side of his forehead and right eyebrow
region with his thumb and index finger
so that any contamination of his hands
would likely be rubbed into the skin of
that area. The erythematous, scaling lesion
with symptoms of itching and burning,
sensitivity to sunlight, hyperesthesia, and
epilation of hairs of the eyebrowis consistent with radiation damage.
The tissue changes are of minimal degree
when considered by general morphologic
criteria. Comparison of pigmented and nonpigmented areas does reveal differences in.
the elastic tissue below the superficial
corium, It is apparent that the moderately
extensive
elastosis,
not
unusual
for
must be presumed that the degree of ex-
posure falls in the range which results in
reversible epithelial changes as described
by Moritz and Henriques.5 In spite of
certain difficulties in interpretation of the
histologic picture, it is felt that the pattern
is not only consistent with, but suggestive of
radiation damage andthat the differences in
the pattern of elastic tissue tend to support
thts conclusion.
The regrowth of white hair in the af-
fected region in contrast to normal dark hair
irregular in outline, fragmented, beaded, and vari-
of the unaffected region is unusual. Regrowth of white hair in regions previously
Diagnosis and Comment
dark has been noted in irradiated animals,t
able in staining reaction.
A diagnosis of beta radiation lesion was
made in this case on the basis of the following considerations. The history of the case
strongly suggests radiation damage since
but so far as the authors are aware has not
been reported in human beings. The more
rapid growth of hair in the affected regions
+ References 6 and 7,
Gomori aldehyde fuchsin for elastica. Reduced about 35% from mag. * 490 (AFIP Neg.
No. 55-19589). Fig. 5—Area beneath depigmented epithelium, presumably involved by radiation, at the area indicated in Figure 2, taken at exactly the same distance beneath the surface
as Figure 4. Note the marked degenerative changes in the elastica. This is distant from
and without any apparent relation to the elastosis changes noted superficially. Fig. 6—From
area indicated in Figure 2 taken at the same depth as Figure 4. Note the marked irregularity,
fragmentation, and beading of elastica. Gomori aldehyde fuchsin for elastica; reduced about
35% from mag. * 490 (AFIP Neg. No. 55-19593).
912915
this
location and age group, might well mask
changes in the superficial subcutaneous tissue. Epithelial changes particularly are absent, other than pigmentary disturbance. It