on Human Being, SONTROL GROUP 4 (i> 33 Cronkite/Bond/Conard about one-fourth of the Marshallese experi- enced itching and burning of the skin and some burning of the eyes with lachrymation. Nausea. vomiting and diarrhea occurred in some Ronechipese. Tite American military person- 5.49 53 57 61 65 69 for the Rongelap., opulation at time osed groups. astic leukemia died in 1972. sure to 1.9 Gy . One case of 1€@ COMparison Dilation > fallout’on ‘nsive. It was gertk. It was “st two days, nel on Rongerik experienced these symptoms to u lesser degree. They were aware of the danger. took shelter in the aluminum buildings, bathed and changed clothes thus greatly reducing the development of skin lesions. On the ninth exposure day, when the medical team conducted extensive physical examinations, there was no evidence of injury to the skin. The temporal sequence in development of skin lesions and epilations is shown in Figure 10. About two weeksafter exposure in the higherdosed group from Rongelap, loss of hair and hyperpigmentation of the skin appeared. During the early stages of development of the cutaneous lesions, itching. burning and slight pain were experienced. With deeper lesions more severe pain was present. The most painful lesions were those on the feet. In the early stages the cutaneous lesions were characterized by hyperpigmented macules, papules or raised placques. They wereinitially small and later tended to coalesce and the larger lesions developed a dry, leathery texture. The pigmented stage of the superficial lesions wasfollowed by dry, scaly desquamation which preceded from the centerof the Jesion outward. leaving a pink to white thin epithelium. As the desquamation proceeded outward, a characteristic appearance of a central depigmented area fringed with an irregular hyperpigmented zone NECK LESIONS-RONGEL AP PERCENT OF TOTAL GROUP ¢ LESIONS -AILINGINAE was seen. Repigmentation began in the central area and spread outward over a period of many weeks and ultimately. the skin returned to a relatively normal appearance. A Tew more serious lesions were seen on the scalp. neck and feet and in one case on the ear. They were characterized by transepidermal necro- sis with wet desquamation resulting in crusting ulcerative lesions. Blisters were only observed on the feet which developed rather large bullae. A few of the lesions on the feet became infected, requiring local antibiotics. Al] lesions healed within about two weeks. Six months after exposure, the skin had returned nearly to normal and by one year pigmentation changes wereslight. In addition to the lesions of the skin. a bluishbrown pigmentation of the fingernails became evident on the 23rd post-exposure day. As the nails grew out. the pigmentation moveddistally and was not evidenta year after exposure. Epilation was correlated with ulceration of the scalp in most instances and thus was primarily due to beta and low energy gamma irradiatron. Regrowth of hair in all individuals commenced during the third month after expoSure and at six months there was regrowth ofhair normal in color, texture and abundance except in the man that had the severe burn ofthe ear. Therapy of Cutaneous Lesions In general. treatment was nonspecific. The superficial lesions were treated with calamine lotion with 1% phenol which relieved the itching and burning. In a fewinstances, pontocaine ointment was used to control the symptoms. During the period of desquamation and oozing, the lesions were washed daily with soap and water and aureomycin ointment was applied. The bullae. if painful, were aspirated with sterile technique followed by a pressure dressing. One case of ulceration was treated with parenteral penicillin for two days. With this one exception systemic antibiotics were not required and were not used. EPILATION-AILINGINAE Thyroid Disease 30 DAYS POST EXPOSURE el counts at Sears after comparison Fig. 10. Time of appearance of skin lesions and epilation for people from Rongelap and Ailinginae. Hypothyroidism —Cretinism Two infants exposed on Rongelap became cretins. Their thyroidal estimated dose may have been as high as 200 Gybut morelikely was 50