-
-
ce ee
-
to the contiguous sweat gland ducts at sites where the latter penetrated the epadertmis,
-
A mar
row zone of parakeratinosis and amorphous debris was stell present between (he stratum
granulosum and the loogely laminated stratum corneum,
Dernmis
The capillary loops in (he dermal papillae, although present, were not unitoroidly dtstinet
Pericytes remained in increased number but fewer lymphocytes were present. Generally,
there appeared to be slight telangiectasis of the capillaries in the pars papillaris and the
superficial pars reticularis (Plate 3.24). There was some edema of the pars papillaris (Plate
3.22). Scattered pigment Jaden chromatophores were irregularly distributed im the papillary
layer (Plate 3.23). In some cases hair shafts in the superficial pars reticularis were quile
narrow, atrophic, and occasionally absent, in others the hair shafts appeared normal. Small
hair follictes (Plate 3.22) and secretory sweat ducts in some cases showed mild atrophy.
Biopsies of three pigmented mild lesions were taken from two of the white Ronyertk
Americans. Only one of the three gave evidence of damage, which was nominal and confined (0
+
the epidermis.
2
3.2.5
Symptomatology and Treatment
On the day of exposure, itching and burning of the skin was prevalent. This subsided and
for a period of 10 to 14 days or longer there was neither subjective nor objective evidence of
skin injury. Hehing and burning regppeared elther prior to or tn the early pigmentation stage.
With the deeper leaiuns there was also path.. Pain was rather marked with the foot lesions.
During the painful period some of the foot legions were also hot and presenteda brawny
edema. A common comptaint was a tenderness in the great toes medial to the mails. However,
visible lesions in thig area were infrequent, This symptom usually preceded the appearanceof
grosslesions elsewhere on the feet. Many*#: the individuals who developed pafnful foot lesions
were observed walking on iir-nevets for several days. The painfulness of the foot lesions may
have resulted from their greater severity, and may have been accentuated by the dependent
nature of the fuot. Some of the lesions of the neck and axilla were painful when turningthe head
or raising the arms. Theacute reaction and pain subsided after a few days. There were mo
constitutional symptoms.
The treatment of skin lesions was largely non-specific. Most of the superficial lesions
were treated with calamine lotion with one per cent phenol, which in most cases relieved the
itching, burning or pain. A few of the painful hyperpigmetited tesions not relieved. by calamine
with phenol were treated with pontocaine ointment, with apparent success. When the epithelium
desquamated the itching was relieved by daily washing withsqgp and water and the application
ofa water soluble vanishing type ointment which kept the injured skin soft and pliable. Raw
areas, which became secondarily infected, were treated by washing with spap aad by the application of aureomycin ointment. Bullous lesions of the feet were left intactas.tou ds no symploms were present. If painful, the bullae were aspirated with sterile techuiqges to remove the
clear striaw-colored fluid. A single aspiration was adequatestace thewultac ‘did nesefill. One
foot lesion developed an extensive, raw weeping ulcer. Pruphylac titanic ilite. wis given for
two days, during which time the lesion developed heatt . -Branulatiah”tigeuc.”Sume al ike lesions Of the skin of the foot remained thickened, less
y and ‘patnful after dgsqwa: a
This was relieved by the use of vaseline or cocoa butts
ear lesion did not heal after desquamation, This was
{a3
ten the tissues. One Ff
t¥@ated with ¥warm boric acid ¢ oniprenses,z
and washing with surgical soap tou remove the eschar. " Granulation-Visisue ioemed.. and-epitheli- ~
um was slowly growing in from the edges of the ulcer when the initial observation period was
terminated 74 days after exposure. Upon resurvey six months after exposure healing was complete, with a depigmented scar remaining as evidence of the previous ulcer.
3.3
EPILATION
The incidence of and time of appearance of epilation in the Rongelap and Ailinginae groups
is illustrated in Tables 3.1, 3.2 and Fig. 3.1. Epilation was first observed on the 14th posst-
7