served with doses of 17,000 rep. The lesions
later showed depigmental centers with hyper-
loss of epithelial structures took place, which
ally exposed over much of their bodies to scattered cathode rays from a 1200 kv primary
beam with exposure time of about 2 minutes
and a rough estimation of dose to the skin of
hetween 1000 and 2000 rep.
The lesions de-
scribed were similar to those reported by
Knowlton ef a/, with a primary erythema developing within 36 hours; secondary erythema
with vesiculation and bullae formation appearing about lz to 14 days later; and, in the
more severely affected, a tertiary phase characterized by further breakdown of the skin.
In comparison with severe roentgen ray reactions these investigators stressed the unique
pertodicity of cathode ray burns, relative absence of deep damage to the skin, less pain,
“rester rapidity of healing, and absence of
pigmentation. These points would apply te
the Marshallese lesions except for the multiphasic reactions and absence of pigmentation.
Cruwford (8) reports a case of cathode ray
burns of the hands which were similar to those
described by Robbins ef ad.
Experimental beta radiation burns in’ human bers have been reported by Low: Beer
(9) and Wirth and Raper (10).
Both inves-
tigators used PB dises applied to the flexor
surface of the arms, forearms, or thighs for
varying lengths of time. Low-Heer reported
“monophasic” skin reactions. He found that a
calculated dose of 143 rep toe the tirst: milllmeter of skin, ignoring self-absorption, pro-
a REP so
pigmented edges (also seen in the prevent
erythema within 6 hours after exposure to a
dose of 635 to 1180 rep of P™ radiation. Mi-
Robtins et a/. (7) reported six cases acc:dent-
on
frat willimeter and bullous, wet desquametion
waa prmiuced by i7,000 rep ta the first nullineter. brythena developed in 3 to 4 days,
followed later by pigmentation and desquamation with higher domes, Keeovery wan ob
Canes).
necessitated skin grafting in some cases.
ataen ee
Dry, scaly, dee-
quamation was produced by 720 rep in the
breakdown of skin with necrosis in areas which
were damaged sufficiently to compromise the
blood supply. Atrophy of the epidermis and
eea
duced a thresheld erythema.
+ eemeomerceh ® “Ope tee
third to the sixth of eighth day, ami was char
acterized by a more severe erythema: (3) The
third phase at & to 12 days. wus characterised
by vesicle and buliee formation. The erythema
spread to new areas during the following 2
weeks, and the active proces subsided by 24 to
32 days. The bullae «irre? ap, and denquamation and epithelization tack place in jem
severely damaged areas; (4) The fourth phase
oe chronic stage was characterized by further
i.
EFFECTS OF IONIZING RADIATION
Wirth and Raper (10) produced primary
nute vesicles with dry, spotty desquamation
were noted with 1180 rep at about the fifth to
sixth weeks post-exposure.
Twenty-three Japaneses fishermen were exposed to the same fallout material which involved the Marshallese and Americans. There
were many similarities in appearance of skin
lesions that developed. Pigmentation was also
common in the Japanese and some degree of
erythema was reported (11) which was not seen
inthe Marshallese,
Distribution of lesions was
hot the same due to different parts of the body
being protected by clothing.
For example, in
the Japanese scalp lesions and epilation were
more common on the crown of the head since
handkerchiefs were usually worn around tne
head leaving the crown exposed. Shoes protected the feet of the Japanese, but lesions of
the hands between thumb and index finger were
conumon, apparently due to handling contaminated fishing lines. Lesions with belt line distribution occurred in the Japanese fishermen
but not the Marshallese. Similar mild lesions
were observed on several American sailors who
were on ships of the task force exposed to fallout. From available information. the severity
and course of the lesions in the Japanese tishermen appeared to be similar to those seen in the
Rongelap Marshallese group.
The lesions in this report did not follow
precisely the same course as those beta radiation
lesions desembed by Knowlton, Robbins, and
others (6-10) and they presented certain unique
fentures which merit further discussion.
Se EN * eee “OER ASS ATTtetera ~ oy
3s