SKIN LESIONS AND EPILATION

39

the vast majority of cases. Such changes have
been generally observed prior to the development of radiation cancer. (c) The lack of any
marked histological damage 6 months after exposure implies good repair. (d) Since lowenergy radiation was chiefly responsible for the
skin lesions, the prognosis appears better because none of 1,100 individuals exposed to low
voltage X-ray for dermatological conditions
developed epidermoid carcinoma5 to 23 years
after treatment (27). (e) Furthermore epitheliomata rarely develop after a single dose
of radiation to the skin (12). (f) Lastly the
incidence of skin cancer in Negroes is one-sixth
to one-ninth the incidence in Caucasians (28)
in the United States.
Other factors make the outlook less favorable: (a) Deeper lesions of the feet and neck
continued to show pigment aberrations and
slight atrophy at 1 year, and one severe ear
lesion showed marked atrophy and scarring
at this time. (b) It is not known whether or
not radiation of the epidermis per se can predispose to malignant change. Since the epidermis
was heavily irradiated in these cases, compared
to the dermis, this becomes an important consideration.
(c) Since many children and
young adults were involved, the life expectancy
of a large numberof the individuals will exceed
the long induction period for the development
of radiation cancer observed in radiologists.
(d) Exposure to tropical sunlight, potentially
carcinogenic in itself, may increase the probability of neoplastic change. (e) The influence
of the sublethal whole-body exposure received
by these people on induction of skin cancer is
not known.

The regrowth of hair, beginning about 9
weeks after exposure in the Marshallese, was
at about the same time as noted in the Japanese

exposure corresponds roughly to the time of
appearanceof epilation in the Japanese exposed
to gammaradiation at Hiroshima and Nagasaki

Fo.Low1nG THE DETONATION of a thermonuclear
device significant amountsof visible radioactive
material were deposited on inhabited atolls producing skin lesions, whole-body radiation injury and some internal deposition of radionu-

The occurrence of epilation 2 to 3 weeks after

(29, 30).

Since the greater amount of epila-

tion occurred over a period of a week to 10 days
there was apparently no phasic response dependent on the growth cycle of the follicles (in-

active, or telogen and active, or anagenfollicles)
as has been reported (81, 32).

S041 24

fisherman (11), and slightly later than the time

of regrowth (6 to 8 weeks) noted in the Japanese bomb casualties. In contrast to the
marked pigmentation changes noted in the
irradiated skin of the Marshallese, there were
no pigment aberrations in the new hair, which
was observed to be of normal texture and abundance at 6 months. Increased graying has been
reported in animals (83-36) but has not been
seen in human beings. Neither was there any
appearance of dark hair in aged individuals
whoalready had gray hair as has been reported
in humanbeings (32, 37, and 38). In the Japanese bomb casualties (30) and the Japanese
fishermen (11) the new hair was also normal in

color, texture, and abundance.

,

The nature of the bluish-brown transverse

bands of pigmentation that developed beneath
the nails is not known. Since it occurred in
the majority of the more heavily exposed Marshallese groups and in all 5 of the American

Negroes, but none of the white Americans, it

appeared to be a response peculiar to darkskinned races. The phenomenon was apparently produced by gammaradiation with a dosage as low as 75 r since this was the estimated
dose that the American Negroes received in the
absence of significant contamination of the

hands.

Sutton (39) has reported a case of simi-

lar fingernail pigmentation which developed in
a negress, following 150 r of soft X-irradiation
to the hands.

3.8

clides.

Summary

The skin lesions in the more heavily

contaminated groups were characterized by
itching and burning of the skin for 2448 hours.
Epilation and skin lesions were observed, be-

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