Il
(fig. 54). Some lesions became secondarily infected;

however,all lesions except one ear lesion healed rapidly
and reepithelized in a week or 10 days. The ear lesion
took about four months to heal. Repigmentation gradually took place in most lesions, and some of the healing
lesions, particularly on the neck, showed development
of hyperpigmentation of a grayish, dusky color and a

thickening of the skin with “orange-peel” appearance.

Biopsy specimens taken from lesions during the third
to fourth week revealed histopathological changes con-

Fig. 6.—Desquamation of back of scalp at 28 days. Epilation occurred
eatlier in desquamated area. Note persistent ulceration of left ear.

sistent with radiation damage (fig. 7). Spotty transepidermal damage with atrophy and flattening of the
rete pegs was a commonfinding, with areasof relatively
normal skin between, emphasizing the particulate nature
of the radioactive material. Cel!s of the malpighian layer
showed pleomorphic nuclei, pyknosis, and cytoplasmic
halos. Focal disorganization of the malpighian and basal
layers was present in extensively damaged areas. In the

dermis, telangiectatic vessels were noted where the over-

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