SKIN LESIONS sN1 PLLA TON
The early symptoms of ttehimg and burn ne
of the skin and eves were protaols due mainly to
skin irradiation from the fallout material.
Ifowever, the chemieai nature of this miter ral
may have contributed te tue tirtiation., Tt aas
Leen noted (12) that orriatine chemucals op
phed during or shortly «fter rrad ation ep
hance the effects of radiation
The lack of prominence of an erythenia was
notable, particularly in view of the severity ct
some of the lesions that geveloped.
Wilhelms
(13) states that erythema oney occurs when the
dose reaching the papillary Jiver exceeds acer
tain level. Perhaps due to the low energy of
the beta radiation the dose to the dermis was in
sufficient to evoke the respouse. On the other
hand, the darkness ¢f the -kin and the wevelop
ment of hyperpigmentation mas have masked
an erythema Microscopically
hyperemia was not prominent.
a) superticral
Wirth and Raper 6/0) point out that tues
were impressed in their studies on Po radiation
of the human skin wich, the ditheults of distin
euishing between true ersthenma and tanning.
particularly in the sain of orimette cadividuals
It was unfortunate that olor t lters were not
available to aid in cistingsushing an erythema
as suggested by Harvis-? if 1
In general. the length of the latent: period
before development of tessons of the skin is con
sidered to be roughly inversely proportions
to the dose of radiation 6.4, 15
La the pres
ent series of cases the relatively ong latent pe
riod 1s suggestive of a lew lose of radiat on
Due to the wide spectrun of bera energies one
particulate distribut on of radioactive mater al.
strict comparisons anno be made with ore
vious experience. fiowever. the later develor.
ment of less severe lesions nohe \ilingiiae ane
Rongerik groups as contrasted with earber de
velopment of more seriGaus lesions im the Rorge
lap group 1s in keeping woth lower skin dose
in the former, and a nigner +k nm dose in the
latter. Its of interest, wewever that the later
period
was
dependent
oo)
anatomical docation
The
were yvenerally the
most
countered, had
wt dor ge:
come
foot
lope
extent
evere
loess severe fesions ocenrring elsewhere on
hehody
lestons ot
to perpod thant.
Tas tageal to assame that the feet
reer ed a figher dose of radiation because of
opowtmet.s te the ground and this may explain
oe sever ty of these lesions. The longer laten.
perod tdesipte oigher dose of radiation) may
w ooelute d to thickness of the epidermis, dif-
ferences iu length of iiterie cycles or other
huracteristies of skin in different
Loe rent
cerns ef the bods
Phe tustopathologteal changes noted, such as
testructive and atrophic changes of the epiTeens, listurbaneces i keratinization, and
of iain follicles, when taken together
UEP TEs
ia consistent with radiation
S217 S14, and 20).
tlie dermis and blood vessels
Poe iinimal dermal injury
injury to the skin
Severe injury to
was not observed.
with severe epi-
{ermal injury isin keeping with the large com.
ponent of low energy beta niaterial present, re-uiting im absorption of the greater portion of
The energy ia the epidermis.
Hyvperpiymentation of injured areas was a
consistent fndiig in the Marshallese and the
\nerican
Negroes.
Pigmented
lesions were
cba observed to a lesser extent im the white
Aonenecans.
Sueh pronounced pigmentation is
ee Hareeteristie of the usual lesions as de~oubed following exposure fo beta or pene‘rotimg radiation, but may be more typical of
hye response to ultra soft roentgen or “Grenz
ries
f.4
Jhere io satisfactory explanation for the
turker dusky-aray color that appeared in some
tthe sk.on lesions as healing progressed.
Vas-
Siar changes or pigment aberrations might
hove oeen responsible The return to near nor-
hit
on this pigmentation by 6 months showed
the feudsienr nature of this change. Phe conPoet apsence of pigmentation at the site of
The deeper foot lesions at 6 months and | year
Ler suggests that the pigment-producing elenent} ip these areas were permanently dant
ied
on
destons, weal
37
'
Phe unique features of the lesions such as
o marked prgtnentation, the absence of obviSanit phasic cesponse, the long latent period,