RCT on gentian violet versus a hydrogel dressing for radiotherapy-induced moist skin desquamation

Abstract

Radiotherapy-induced moist desquamation is a significant problem but there is a paucity of randomised data on which to base treatment decisions. The current prospective randomised trial compared gentian violet (GV) to a hydrogel dressing in this context. Thirty patients undergoing radiotherapy to the head and neck region or breast who had developed moist desquamation in the radiotherapy field were randomised to treatment with 0.5% aqueous gentian violet (GV) (n=16) or a hydrogel dressing (n=14). The area of desquamation was regularly measured until healing or withdrawal from the study. The likelihood of healing with the hydrogel was greater than GV with a hazard ratio for healing of 7.95 (95% CI 2.20-28.68; p=0.002). The median time to healing for hydrogel was 12 days but had not been reached for GV by 30 days. Over the first 14 days the median'area under curve' of moist desquamation for GV was 82.6 cm2 (range 31.8-320.7 cm2) and that for hydrogel 20.0 cm2 (range 3.8-301.0 cm2) (difference significant at p=0.003). Ten of 16 patients treated with GV withdrew from the study (due to stinging in five and failure to heal in five) compared with two of the 14 treated with hydrogel (difference significant at p=0.021). Hydrogel dressings are more likely to heal radiotherapy-induced moist desquamation and are better tolerated than GV.