1194
J.A.M.A., July 13, 1957
FALL-OUT RADIATION—CONARDET AL.
pared with unexposed Japanese children, whereas
there waslittle difference between the female children
of the two groups.
Residual Radiation Lesions of the Skin.—Residual
per primam. There was no evidence that the intense
and only one residual lesion was observed among the
18 Ailingnae people. The latter group was exposed to
considerably less fall-out, and they had developed
much milderlesions.
Biopsy specimens were taken from 15 residual] lesions. Comparison was made with control biopsy
specimens taken from the neck, the antecubital fossa,
and the dorsum of the foot from nonexposed Marshallese. Specially stained sections from earlier biopsy
specimens were not yet available at the time of writing. A detailed description of comparative changes in
lesions were present in 15 of the Rongelap people,
sunlight to which these people are exposed had adversely affected any of the Jesions. There appeared to
be no evidence of any change which would suggest
malignancy.
the present sections with earlier sections. however,
will be made the subject of a future report.
The following changes were noted in the two-year
postexposure biopsysections: 1, No neoplastic lesions
were present. 2. No epidermal cellular alterations suggestive of a precancerous lesion were seen. 3. In some
sections, acanthosis, absence of pigment in the basal
layer, and atrophy and benign dyskeratosis were noted
occasionally in the stratum spmosum of the epidermis.
4. The papillary layer of the dermis frequently showed
distinct degenerative alterations in the collagen, characterized usually by homogenization of the collagen
and what appeared to be an alteration in the distri-
bution of mucopolysaccharide when compared with
contro] sections. Occasionally mucin was seen in areas
of degeneration in the dermis. 5. Capillary dilatation
was noted in the dermis and, in one patient, in the
hypodermis. Medial degeneration in an artery was
noted in one patient. 6. The biopsy specimen from a
single patient showed increase in heavy dense bands
Fig. 1,—Photograph showing superficial lesion due to beta
radiation of back of the neck in a 15-year-old girl about six
weeks after exposure. Note areas at sides of neck that have
desquamated as contrasted to the center region, which shows
hyperpigmented thickening of skin, which gradually desquamated also.
The majority of all lesions showed improvement.
Almost all of the early superficial lesions were completely healed at this time. without anv appurent residual changes. Figure 1 shows an early superficial
lesion of the neck, and figure 2 shows the completely
healed appearance of this lesion at the time of this
study. Lesions that showed dusky, gray hyperpigmentation during the first year after exposure ( mostly on the
back of the neck} showed less hyperpigmentation, and
in most cases there had developed a more normal
mahoganycolor. All residual depigmented lesions continued to show varying degrees of repigmentation, and
in some cases repigmentation was complete. The lesions showing the most residual change were those in
three cases of lesions of the dorsumof the feet and one
lesion of the ear. These lesions showed varying amounts
of scarring and atrophyof the skin, with some adherence of the skin to the subcutaneous tissues (fig.
3 and 4). The center of the ear lesion was fixed to the
underlying cartilage. Even in these lesions, however,
there was no evidence of degradation or breakdown
of the tissues, and in no case was surgical repair considered necessary at the time of this study. Although
it was believed possible that these lesions might not
respond well after trauma, all biopsy lesions healed
Fig, 2.—-Photograph in same patient as figure 1 two years
after exposure showing complete healing of lesion.
of collagen in both the papillary and reticular layers
of the dermis. Most of these changes were consistent
with late radiation changes in the skin previously
reported.
Hematological Findings.—As in the past, the groups
were divided according to age and sex in order to
make appropriate comparisons of the various blcod
elements.