hyperpigmentation, The macules and papules (1 {62° min in diameter) usually oceurred in
clusters and sometimes coalesced into larger lesions. ‘Che latter were cha ractertstically
found on the sealp, neck, and the antecubital fossae. ‘The raised phiques varied in size froma
few millimeters to several centimeters in diameter, were (hick, rough, dry, and hada deathery
feel. ‘Phis type of lesion occurred predominantly on the feet and in the antecubital fossae and
fo a much lesser extent on the neck. Areas of mcreased pigmentation also occurred on the
°
bonbs, Crunk, and on the face.
The majority of the lesions were superficial without blisters. A few days after appearance,
dry, scaly desquamation occurred in the central portion of the hyperpigmenuted areas. The des
quamation tefta pink to white epithelium nat remarkably different in texture from the surTable 3.10
LESIONS IN RONGELAP GROUP
Type of
Age 0-5
Age 6-15
Age 16 & Over
‘Total Group
du
‘inte
Media Ui
of First
Observation
Lesion
(13 people)
C13 people)
(38 people)
(64 people)
of Lesions *
Per Cent of Total in Age Group having Indicated Lesion
Bpilation
{ plus
7.6
38.4
[3.8
7.2
7
2 plus
3 plus
38.6
53.8
30.7
23.0
5.6
8.3
17.2
22.0
7
16
100.0
92.1
27.6
56.2
16
17
Total
Skin Lesions
Anus-Groin
u.4
0.0
0,0
7.8
Seaip
hoa.d
100,0
37.0
62.5
8
Neck
G2
76.9
68,0
70.38
Zt
Axtila
Ol
7.6
15.7
23.4
2i
34.2
18.4
34.4
21.8
Antecubital
eg Fossac
Boas-wrists
30.7
30,7
“Feet
23.0
Arms
15.%
Legs
Trunk
Nail Pigmentation
2.
“OA4
23.0
53.8
15.3
53.0
45.3
4.3
10.3
-
28
33
28
12.5
31
7.6
23.0
7.8
aN
15.3
23.0
4.3
9.4
33
61.5
100.0
95,0
89.0
38
* Post-exposure davs.
rounding skin. As the desquamation proceeded outward, the areas developed a characteristic
appearance of a central depigmented area fringed with a hyperpigmented zone. Al a later stage,
pigmentation began in the central areas and spread outwards. After a few weeks the cycle was
completed, leaving in most instances a relatively normal appearing skin.
Approximately 20 per cent of the Rongelap group developed lesions which were more se vere. These lesions might be considered as comparable to second degree thermal burns. The
deeper lesions occurred principally on the feet and (a a lesser extent on the scarp and qeck and
in one case on the ear,
Blister formation was not common.
However, on the feet, some large
bullae (blisters) appeared. After a few days, the hyperpigmented lesions showed wet desquamiation with weeping and crusting, leaving depigmented raw surfaces of varying area. Someof
these lesions became secondarily infected. Epithelium rapidly covered the ulcerated areas
within a week to 10 days. Pigmentation followed during the next few weeks. As healing occurred many of the more severe lesions (particularly on the neck and antecubital fossae) developed
a thickening of the skin with an “orange peel” appearance and a dusky, grayish-brown color
(see Plate 3.4).
35
oe
eee
8
ote
ew
1
oe
va
.
.