“KIN
LESIONS
touched the nape of ‘he ae ko
Neck lesions are
illustrated in Plate i 4
Vathars desions ¢ Plate
11) usually consisted foccalessing papules
Antecubital fossa lessons were iaracterized "ys
formation
of
thickener,
daques.
NiO RR OLA TOS
(fF cogsnertation changes were mild. Foot
rons mid bot repigmented at sites of deepest
haivetnent and some atrophy of the skin in
Hes
ful due to excoriation of tee cpigernus
“These
healed rapidly
Deeper lesions were see oi the scalp. neck,
Touey were char
acterized by transep dermal vecrosis with wet
desquamation leaving weeriny, rusting ulcera
tious. Vesiculation was ot observed except
with foot lesions which developed bullae. fre
quently several centimeters in dinmeter. beneath
thickened
pigmented
olaques
‘These
foot
lesions occurred on tie dorsum of the feet and
between the toes. niv cne case showed des
quamation on the soles «f he feet.
After
several days the bul:ae ruptiree and desqua
mated leaving raw uleers
Some of these
lesions, particularly « f the feet. became second
arily infected requiring untibsorics.
most of the lesions healed
capidly
However
and new
epithelium covered tae alerated areas within
a week to 10 days.
Foot lesions are tlustrated
in Plates 5-10) One ear lesion Plates [- 1)
took several months to Lea
The repigmentaticn of cone ceeper esions
presented abnormalsies
‘
feep, were pain
feet,and in one caseoiythertir
Nees lesions often
developed a dusky, grayish orewn pigmentation
associated with a thi kene:
rinige peel” ap
pearance.
Histolog en: ippearance oof ep
dermal rugosity was ilso roted 2 these lestons
(see section on histopatho ogy
In addition,
At examuna
tion 6 months and 1 year efter tue exposure, the
skin appeared norma wh ne res:dual changes
in the vast majority 07 nse:
‘Towever some of
the deeper lesions con inuec to shawevidence if
residual damage. Foreme-t mong these was
the ear lesion which md healed with consider
able scarring, atrophy. sal ng of the epiuermis
and vross telangiecta ss,
soot onths the |.
perpigmentation and thickens ig f the skin of
the neck lesions had rreat|
ds fecoonce by
Microscopic Appearance
Hiopsies were taken of seven neck, and one
axt dary desion m the Rongelap group during
Ihe turd to fourth week after exposure. At
the tine of biopsy these lesions were in the hyperpigmented stage with little or no desquama-
noi
Most cf the biopsies were taken from in-
ais duals with lesions of average severity. A
second sertes of biopsies (repeats in three inwiv.duats were taken from this group, + at
the seventh week and 5 at the eighth week post-
exposure.
These were taken from the neck and
antecubital fossae.
All of these lesions had
desquamated and the depigmented skin had repigmented te a dusky, vray color with some
tuickeniny of the skin «“orange-peel” appearNHtltie yp,
plates U5 and 27.
Biopsies were not
taken from .leerative lesions or from the feet
becuase of tue danger of infection. A third
ser es of 1) biopsies were taken from the Rongelip sronp ait 6 months along with several con-
Tro tiopsies "rom unexposed natives. Material
wa obtamed in many cases adjacent to sites of
Preyvicds biopsies
roa
.
ithi
dotioosy
wounds: healed rapidly
within
a‘
ee ls cays sith no secondary complica-
Ttibs
[he macroscopic findings are summarized as
f iJ
the deeper lesions of the “er fa lea to rene
ment, remaining pina or cette
Geers vars parent,
Severn
babies and one woman dessicpec lesious im the
anal region which, though no
31
iW
tars septes~ urd to qth week.
iEpidermis.
Devnsep dermal damage was noted with a few
Htervening
arendes showing less damage
Paresh and Ze
The epidermis in the most
extensivels a volved areas showed considerable
ivrepdy with flattening of the rete pegs and in
tlaces che epidermis was reduced to a thickness
footy cedis ¢Phates 2b. 23, and 24). The cells
of he malpighian laver showed pleomorphic
Woe
»
oyknosis and evtoplusmic halos, giant
tera
og "ew nstances multinucleated cells.