Abstract
Cases of radiation-induced skin injury after fluoroscopically guided procedures have been reported since 1996, though the majority of them have been published in Radiology and Cardiology literature, less frequently in Dermatology journals. Chronic radiation dermatitis induced by fluoroscopy can be difficult to diagnose; a high grade of suspicion is required. We report a case of an obese 46-year-old man with hypertension, dyslipidemia, and severe coronary artery disease. He developed a pruritic and painful atrophic ulcerated skin plaque over his left scapula, six months after fluoroscopically guided stent implantation angioplasty. The diagnosis of radiodermatitis was confirmed histologically. We report this case to emphasize the importance of recognizing fluoroscopy as a cause of radiation dermatitis. A good clinical follow-up at regular intervals is important after long and complicated procedures, since the most prevalent factor for injury is long exposure time.
Highlights
Cases of radiation-induced skin injury after fluoroscopically guided procedures have been reported since 1996; diagnosis and treatment of such lesions remain difficult [1]
Chronic radiation dermatitis induced by fluoroscopy can be difficult to diagnose
A hydrophilic ointment was indicated on the rest of the plaque. This case emphasizes the importance of fluoroscopic procedures as a cause of radiation dermatitis
Summary
Cases of radiation-induced skin injury after fluoroscopically guided procedures have been reported since 1996; diagnosis and treatment of such lesions remain difficult [1]. Fluoroscopy-induced chronic radiation dermatitis often requires a high clinical suspicion to establish a correct diagnosis [2]. Ionizing radiation during interventional procedures is often underestimated. The period between radiation exposure and manifestation of skin injuries varies, from 15 days up to months or years. The incidence of radiodermatitis after percutaneous coronary interventions by X-ray fluoroscopic procedures is rising; case reports have been increasingly documented. The skin lesions encompass a wide spectrum, such as erythema, telangiectasias, atrophy, hyperpigmentation and hypopigmentation, necrosis, chronic ulceration, and squamous cell carcinoma [4]. Chronic radiation dermatitis induced by fluoroscopy can be difficult to diagnose. Inflammation, and presence of hyperkeratosis are helpful diagnosing this entity from others such as morphea and lichen sclerosus [5]
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