2
EYTECTS OF JONTIEING RADIATION
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were abssat until the visible lesions developed.
Dering the early stages of development of the
lesions, itching, burning and slight pain were
experienced with the more superficial lesions.
With deeper lesions pain was more severe. The
deeper foot lesions were the most painful and
cansed some of the people to walk on their
heole fer several days during the acute stages.
Mome of the more severe lesions of the neck
and axilla were painful when turning the head
or raising the arms. The lesions did not
produce any constitutional symptoma.
3.3
3.31
Gros Appearence
The time of appearance and the severity of
the lesions varied with the degree of skin contamination in the different groups. The Ronge-
lap group, which showed greatest radicective
contamination of the skin (according to instru-
ment readings) were the first to develop lesions
and epilation at about 12 to 14 days after the
accident. They also had the st severe jesions.
Skin lesions in the lesser exposed Ailinginse
and Rongerik groups developed approximately
one week after {hose in the Rongelap group, and
The Utirik
group did not develop any lesions which could
be attributed to irradiation of the skin. The
incidence of ulcerating lesions in the different
groupe reflected the relative severity of the skin
injury. Twenty percent of the Rongelap people
developed ulcerative lesions while only five percent of the Ailinginae and none of the Rongerik
people developed ulcerative lesions. Ninety
percent of the Rongelap and Ailinginae groups
developed jesions, compared to only forty per-
cent of the Rongerik group. There were more
lesions per individual in the Rongelap group
than in the Ailinginae or Rongerik groups.
A
comparison of the incidence and time of appear-
ance of epilation and neck lesions in the two
gToups is illustrated graphically in Figure 3.1.
* The description of lesions refera tu the Warnhallese
unless otherwise indicated.
ee
a
ered by clothing during the fallout. The majority of individuals developed mektiple lesions
(particularly the Rongelap growp), most of
which were superficial. There was 2 difference
of several days in the latent period before development of lesions on various akin arves. The
order of appearance was roughly 20 follows:
scalp (with epilation), neck, axillary region,
antecubital fosse, feet. arms, legs, aad trunk.
Lesions on the flexor surfaces in general preceded those on the extensor surfaces. Tables
3.1 and 3.2 show incidence according to age and
Description of Skin Lesions*
were leas severe and extensive.
Nearly all of the lesions were spotty and de-
veloped on exposed parts of the body not cov-
time of appearance of lesions in the various
groups.
In the early stages al] lesions were characterised by hyperpigmented macuies, papules, or
raised plaques. (Plate 1.) These frequently
were snall, 1-2 mm. areas at first, but tended to
coalesce in a few days into larger lesions, with
a dry, leathery texture.
The pigmented stage of the superficial lemons
within several days was followed by dry, scaly
desquamation which proceeded from the center part of the lesion outward, leaving a pink
to white thinned epithelium. As the desquamation proceeded outward, a characteristic ap-
pearance of a central depigmented area fringed
with an irregular hyperpigmented sone was
seen (Plates 2 and 3). Repigmentation began in
the central area and spread outward over the
next few weeks leaving skin of relatively nor-
mal appearance. Plates 3, 4, 11, and 12 show
superticial lesions as they appeared initially and
six months later. The mildest manifestation of
akin injury was the development of a blotchy
increased pigmentation of the skin with barely
perceptible deaquamation. Such lesions were
most often noted on the face and trunk.
Epilation was usually accompanied by scalp
lesions (Plates 13, 17 and 19).
Some indi-
viduals developed new scalp lesions cver a
period of about a month. Neck lesions usually
had a “necklace” distribution, beginning anteriorly and spreading posteriorly. These were
more severe in women in whom thick hair