Advanced search

Online first
Review paper
Published online: 2024-05-23

open access

View PDF Download PDF file
Page views 136
Article views/downloads 53
Get Citation

Connect on Social Media

Connect on Social Media

Radiation-induced skin injury in the head and neck region: pathogenesis, clinics, prevention, treatment considerations and proposal for management algorithm

Jakub Pazdrowski1, Justyna Gornowicz-Porowska2, Joanna Kaźmierska3, Violetta Krajka-Kuźniak4, Adriana Polanska5, Michał Masternak6, Mateusz Szewczyk1, Wojciech Golusiński7, Aleksandra Danczak-Pazdrowska5

Abstract

Worldwide increase of head and neck cancers ranks these malignancies among top causes of cancer in human population. Radiation induced skin injury (RISI) is one of the major side effects of radiotherapy (RT). Skin of the neck is exposed to radiation due to necessity of therapeutic or prophylactic (elective) irradiation of neck lymph nodes and target organs, including the larynx and hypopharynx. The location of the neck exposes these regions of the skin to various additional exposomes such as ultraviolet radiation (UVR), pollution and cigarette smoke. There are many controversies or inconsistencies regarding RISI, from molecular aspects and therapy to terminology. There is lack of high-quality and large-sample studies in both forms of RISI: acute (aRISI) and chronic (cRISI). Finally, no gold standards in the management of aRISI and cRISI have been established yet.  In this article, the authors discuss the pathogenesis, clinical picture, prevention and clinical interventions and present a proposed treatment algorithm.

Keywords: radiotherapy side effectsradiation induced skin injuryradiodermatitis

Article available in PDF format

View PDF Download PDF file

References

  1. Rahman QB, Iocca O, Kufta K, et al. Global Burden of Head and Neck Cancer. Oral Maxillofac Surg Clin North Am. 2020; 32(3): 367–375.
    CrossRefPubMed
  2. Burnett LR, Hughes RT, Rejeski AF, et al. Review of the Terminology Describing Ionizing Radiation-Induced Skin Injury: A Case for Standardization. Technol Cancer Res Treat. 2021; 20: 15330338211039681.
    CrossRefPubMed
  3. Paldor M, Levkovitch-Siany O, Eidelshtein D, et al. Single-cell transcriptomics reveals a senescence-associated IL-6/CCR6 axis driving radiodermatitis. EMBO Mol Med. 2022; 14(8): e15653.
    CrossRefPubMed
  4. Chow LQM. Head and Neck Cancer. N Engl J Med. 2020; 382(1): 60–72.
    CrossRefPubMed
  5. Bontempo Pd, Ciol MA, Menêses AG, et al. Acute radiodermatitis in cancer patients: incidence and severity estimates. Rev Esc Enferm USP. 2021; 55: e03676.
    CrossRefPubMed
  6. Haftek M, Roy DC, Liao IC. ARTICLE: Evolution of Skin Barrier Science for Healthy and Compromised Skin. J Drugs Dermatol. 2021; 20(4): s3–s9.
    CrossRefPubMed
  7. Wong RKS, Bensadoun RJ, Boers-Doets CB, et al. Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC Skin Toxicity Study Group. Support Care Cancer. 2013; 21(10): 2933–2948.
    CrossRefPubMed
  8. Leventhal J, Young MR. Radiation Dermatitis: Recognition, Prevention, and Management. Oncology (Williston Park). 2017; 31(12): 885–7, 894.
    PubMed
  9. Seité S, Bensadoun RJ, Mazer JM. Prevention and treatment of acute and chronic radiodermatitis. Breast Cancer (Dove Med Press). 2017; 9: 551–557.
    CrossRefPubMed
  10. Curran D, Giralt J, Harari PM, et al. Quality of life in head and neck cancer patients after treatment with high-dose radiotherapy alone or in combination with cetuximab. J Clin Oncol. 2007; 25(16): 2191–2197.
    CrossRefPubMed
  11. Lazarev S, Gupta V, Ghiassi-Nejad Z, et al. Premature discontinuation of curative radiation therapy: Insights from head and neck irradiation. Adv Radiat Oncol. 2018; 3(1): 62–69.
    CrossRefPubMed
  12. Abel E, Silander E, Nyman J, et al. Long-Term Aspects of Quality of Life in Head and Neck Cancer Patients Treated With Intensity Modulated Radiation Therapy: A 5-Year Longitudinal Follow-up and Comparison with a Normal Population Cohort. Adv Radiat Oncol. 2020; 5(1): 101–110.
    CrossRefPubMed
  13. Nichols AC, Theurer J, Prisman E, et al. Randomized Trial of Radiotherapy Versus Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma: Long-Term Results of the ORATOR Trial. J Clin Oncol. 2022; 40(8): 866–875.
    CrossRefPubMed
  14. Blanchard P, Lee A, Marguet S, et al. MAC-NPC Collaborative Group. Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis. Lancet Oncol. 2015; 16(6): 645–655.
    CrossRefPubMed
  15. Bernier J, Cooper JS, Pajak TF, et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck. 2005; 27(10): 843–850.
    CrossRefPubMed
  16. Cooper JS, Zhang Q, Pajak TF, et al. Long-term follow-up of the RTOG 9501/intergroup phase III trial: postoperative concurrent radiation therapy and chemotherapy in high-risk squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys. 2012; 84(5): 1198–1205.
    CrossRefPubMed
  17. Lacas B, Bourhis J, Overgaard J, et al. MARCH Collaborative Group. Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis. Lancet Oncol. 2017; 18(9): 1221–1237.
    CrossRefPubMed
  18. Lacas B, Carmel A, Landais C, et al. MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 107 randomized trials and 19,805 patients, on behalf of MACH-NC Group. Radiother Oncol. 2021; 156: 281–293.
    CrossRefPubMed
  19. McCart EA, Thangapazham RL, Lombardini ED, et al. Accelerated senescence in skin in a murine model of radiation-induced multi-organ injury. J Radiat Res. 2017; 58(5): 636–646.
    CrossRefPubMed
  20. Chen H, Wu M, Li G, et al. Association between XRCC1 single-nucleotide polymorphism and acute radiation reaction in patients with nasopharyngeal carcinoma: A cohort study. Medicine (Baltimore). 2017; 96(44): e8202.
    CrossRefPubMed
  21. Barnett GC, Coles CE, Elliott RM, et al. Independent validation of genes and polymorphisms reported to be associated with radiation toxicity: a prospective analysis study. Lancet Oncol. 2012; 13(1): 65–77.
    CrossRefPubMed
  22. Oliva D, Nilsson M, Strandéus M, et al. Individual Genetic Variation Might Predict Acute Skin Reactions in Women Undergoing Adjuvant Breast Cancer Radiotherapy. Anticancer Res. 2018; 38(12): 6763–6770.
    CrossRefPubMed
  23. Safwat A, Bentzen SM, Turesson I, et al. Deterministic rather than stochastic factors explain most of the variation in the expression of skin telangiectasia after radiotherapy. Int J Radiat Oncol Biol Phys. 2002; 52(1): 198–204.
    CrossRefPubMed
  24. Hornhardt S, Rößler U, Sauter W, et al. Genetic factors in individual radiation sensitivity. DNA Repair (Amst). 2014; 16: 54–65.
    CrossRefPubMed
  25. Hubenak JR, Zhang Q, Branch CD, et al. Mechanisms of injury to normal tissue after radiotherapy: a review. Plast Reconstr Surg. 2014; 133(1): 49e–56e.
    CrossRefPubMed
  26. Wang J, Guo C, Gong X, et al. The impacts of genetic polymorphisms in genes of base excision repair pathway on the efficacy and acute toxicities of (chemo)radiotherapy in patients with nasopharyngeal carcinoma. Oncotarget. 2017; 8(45): 78633–78641.
    CrossRefPubMed
  27. Pratesi N, Mangoni M, Mancini I, et al. Association between single nucleotide polymorphisms in the XRCC1 and RAD51 genes and clinical radiosensitivity in head and neck cancer. Radiother Oncol. 2011; 99(3): 356–361.
    CrossRefPubMed
  28. Alsbeih G, Al-Harbi N, Al-Hadyan K, et al. Association between normal tissue complications after radiotherapy and polymorphic variations in TGFB1 and XRCC1 genes. Radiat Res. 2010; 173(4): 505–511.
    CrossRefPubMed
  29. Li H, You Y, Lin C, et al. XRCC1 codon 399Gln polymorphism is associated with radiotherapy-induced acute dermatitis and mucositis in nasopharyngeal carcinoma patients. Radiat Oncol. 2013; 8: 31.
    CrossRefPubMed
  30. Liu R, Bian Y, Liu L, et al. Molecular pathways associated with oxidative stress and their potential applications in radiotherapy (Review). Int J Mol Med. 2022; 49(5).
    CrossRefPubMed
  31. Nakagami Y. Nrf2 Is an Attractive Therapeutic Target for Retinal Diseases. Oxid Med Cell Longev. 2016; 2016: 7469326.
    CrossRefPubMed
  32. Martemucci G, Costagliola C, Mariano M, et al. Free Radical Properties, Source and Targets, Antioxidant Consumption and Health. Oxygen. 2022; 2(2): 48–78.
    CrossRef
  33. Kwon KR, Alam MdB, Park JH, et al. Attenuation of UVB-Induced Photo-Aging by Polyphenolic-Rich Spatholobus Suberectus Stem Extract Via Modulation of MAPK/AP-1/MMPs Signaling in Human Keratinocytes. Nutrients. 2019; 11(6).
    CrossRefPubMed
  34. Hwang JK. Effects of macelignan isolated from Myristica fragrans Houtt. on UVB-induced matrix metalloproteinase-9 and cyclooxygenase-2 in HaCaT cells. J Dermatol Sci. 2010; 57(2): 114–122.
    CrossRefPubMed
  35. Wang Y, Tu W, Tang Y, et al. Prevention and treatment for radiation-induced skin injury during radiotherapy. Rad Med Prot . 2020; 1(2): 60–68.
    CrossRef
  36. Krajka-Kuźniak V, Baer-Dubowska W. Modulation of Nrf2 and NF-κB Signaling Pathways by Naturally Occurring Compounds in Relation to Cancer Prevention and Therapy. Are Combinations Better Than Single Compounds? Int J Mol Sci. 2021; 22(15).
    CrossRefPubMed
  37. Singh V, Gupta D, Arora R. NF-kB as a key player in regulation of cellular radiation responses and identification of radiation countermeasures. Discoveries (Craiova). 2015; 3(1): e35.
    CrossRefPubMed
  38. Iglesias-Bartolome R, Patel V, Cotrim A, et al. mTOR inhibition prevents epithelial stem cell senescence and protects from radiation-induced mucositis. Cell Stem Cell. 2012; 11(3): 401–414.
    CrossRefPubMed
  39. Lam EWF, Brosens JJ, Gomes AR, et al. Forkhead box proteins: tuning forks for transcriptional harmony. Nat Rev Cancer. 2013; 13(7): 482–495.
    CrossRefPubMed
  40. Kim JM, Yoo H, Kim JY, et al. Metformin Alleviates Radiation-Induced Skin Fibrosis via the Downregulation of FOXO3. Cell Physiol Biochem. 2018; 48(3): 959–970.
    CrossRefPubMed
  41. Wang J, Xu Z, Wang Z, et al. TGF-beta signaling in cancer radiotherapy. Cytokine. 2021; 148: 155709.
    CrossRefPubMed
  42. Yang Yu, Zhou H, Zhang Ge, et al. Targeting the canonical Wnt/β-catenin pathway in cancer radioresistance: Updates on the molecular mechanisms. J Cancer Res Ther. 2019; 15(2): 272–277.
    CrossRefPubMed
  43. Lee DW, Lee WJ, Cho J, et al. Inhibition of Wnt signaling pathway suppresses radiation-induced dermal fibrosis. Sci Rep. 2020; 10(1): 13594.
    CrossRefPubMed
  44. Pazdrowski J, Polaſska A, Kaźmierska J, et al. Skin barrier function in patients under radiation therapy due to the head and neck cancers - Preliminary study. Rep Pract Oncol Radiother. 2019; 24(6): 563–567.
    CrossRefPubMed
  45. Behroozian T, Milton LT, Shear NH, et al. Radiation dermatitis assessment tools used in breast cancer: A systematic review of measurement properties. Support Care Cancer. 2021; 29(5): 2265–2278.
    CrossRefPubMed
  46. Finkelstein S, Kanee L, Behroozian T, et al. Comparison of clinical practice guidelines on radiation dermatitis: a narrative review. Support Care Cancer. 2022; 30(6): 4663–4674.
    CrossRefPubMed
  47. Nevens D, Duprez F, Daisne JF, et al. Radiotherapy induced dermatitis is a strong predictor for late fibrosis in head and neck cancer. The development of a predictive model for late fibrosis. Radiother Oncol. 2017; 122(2): 212–216.
    CrossRefPubMed
  48. Pavy JJ, Denekamp J, Letschert J, et al. EORTC Late Effects Working Group. Late effects toxicity scoring: the SOMA scale. Radiother Oncol. 1995; 35(1): 11–15.
    CrossRefPubMed
  49. Hoeller U, Tribius S, Kuhlmey A, et al. Increasing the rate of late toxicity by changing the score? A comparison of RTOG/EORTC and LENT/SOMA scores. Int J Radiat Oncol Biol Phys. 2003; 55(4): 1013–1018.
    CrossRefPubMed
  50. Mao MH, Zhang J, Zhang JG. Comparing the RTOG/EORTC and LENT-SOMA scoring systems for the evaluation of late skin toxicity after I seed brachytherapy for parotid gland cancer. Brachytherapy. 2017; 16(4): 877–883.
    CrossRefPubMed
  51. Xie Y, Wang Q, Hu T, et al. Risk Factors Related to Acute Radiation Dermatitis in Breast Cancer Patients After Radiotherapy: A Systematic Review and Meta-Analysis. Front Oncol. 2021; 11: 738851.
    CrossRefPubMed
  52. Gosselin T, Ginex PK, Backler C, et al. ONS Guidelines™ for Cancer Treatment-Related Radiodermatitis. Oncol Nurs Forum. 2020; 47(6): 654–670.
    CrossRefPubMed
  53. Behroozian T, Goldshtein D, Ryan Wolf J, et al. Multinational Association of Supportive Care in Cancer (MASCC) Oncodermatology Study Group Radiation Dermatitis Guidelines Working Group. MASCC clinical practice guidelines for the prevention and management of acute radiation dermatitis: part 1) systematic review. EClinicalMedicine. 2023; 58: 101886.
    CrossRefPubMed
  54. Tenorio C, de la Mata D, Leyva JA, et al. Mexican radiationdermatitis management consensus. Rep Pract Oncol Radiother. 2022; 27(5): 914–926.
    CrossRefPubMed
  55. Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991; 21(1): 109–122.
    CrossRefPubMed
  56. Kawamura M, Yoshimura M, Asada H, et al. A scoring system predicting acute radiation dermatitis in patients with head and neck cancer treated with intensity-modulated radiotherapy. Radiat Oncol. 2019; 14(1): 14.
    CrossRefPubMed
  57. Bonomo P, Talamonti C, Desideri I, et al. Analysis of skin dose distribution for the prediction of severe radiation dermatitis in head and neck squamous cell carcinoma patients treated with concurrent chemo-radiotherapy. Head Neck. 2020; 42(2): 244–253.
    CrossRefPubMed
  58. Bruand M, Salleron J, Guihard S, et al. Acute skin toxicity of conventional fractionated versus hypofractionated radiotherapy in breast cancer patients receiving regional node irradiation: the real-life prospective multicenter HYPOBREAST cohort. BMC Cancer. 2022; 22(1): 1318.
    CrossRefPubMed
  59. Jamora K, Cruz-Lim EM, Cereno RE, et al. Hypofractionated radiotherapy in postmastectomy locally advanced breast cancer: an interim report on acute toxicities and dosimetry. Rep Pract Oncol Radiother. 2022; 27(6): 943–953.
    CrossRefPubMed
  60. Malik NH, Kim MS, Chen H, et al. Stereotactic Radiation Therapy for De Novo Head and Neck Cancers: A Systematic Review and Meta-Analysis. Adv Radiat Oncol. 2021; 6(1): 100628.
    CrossRefPubMed
  61. Langendijk JA, Oosting SF. Grading system and management guidelines for dermatitis induced by head and neck radiotherapy plus cetuximab: clinical validation required. Ann Oncol. 2011; 22(10): 2157–2159.
    CrossRefPubMed
  62. Fu KK, Pajak TF, Trotti A, et al. A Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: first report of RTOG 9003. Int J Radiat Oncol Biol Phys. 2000; 48(1): 7–16.
    CrossRefPubMed
  63. Chen Z, Dominello MM, Joiner MC, et al. Proton versus photon radiation therapy: A clinical review. Front Oncol. 2023; 13: 1133909.
    CrossRefPubMed
  64. Heukelom J, Fuller CD. Head and Neck Cancer Adaptive Radiation Therapy (ART): Conceptual Considerations for the Informed Clinician. Semin Radiat Oncol. 2019; 29(3): 258–273.
    CrossRefPubMed
  65. Chen A, Yoshizaki T, Hsu S, et al. Image-guided adaptive radiotherapy improves acute toxicity during intensity-modulated radiation therapy for head and neck cancer. J Radiat Oncol. 2017; 7(2): 139–145.
    CrossRef
  66. Sher DJ, Avkshtol V, Lin MH, et al. Acute Toxicity and Efficiency Outcomes in the DARTBOARD Randomized Trial of Daily Adaptive Radiotherapy for Head and Neck Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys. 2023; 117(4): e6.
    CrossRef
  67. Adelstein DJ, Li Yi, Adams GL, et al. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol. 2003; 21(1): 92–98.
    CrossRefPubMed
  68. Krishnamurthy S, Ahmed I, Bhise R, et al. The dogma of Cetuximab and Radiotherapy in head and neck cancer - A dawn to dusk journey. Clin Transl Radiat Oncol. 2022; 34: 75–81.
    CrossRefPubMed
  69. Bernier J, Russi EG, Homey B, et al. Management of radiation dermatitis in patients receiving cetuximab and radiotherapy for locally advanced squamous cell carcinoma of the head and neck: proposals for a revised grading system and consensus management guidelines. Ann Oncol. 2011; 22(10): 2191–2200.
    CrossRefPubMed
  70. Giro C, Berger B, Bölke E, et al. High rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer: results of a survey in EORTC institutes. Radiother Oncol. 2009; 90(2): 166–171.
    CrossRefPubMed
  71. Greive K. Cleansers and moisturisers: The basics. Wound Pract Res J Aust Wound Manag Assoc. 2015; 23: 76–81.
  72. Mijaljica D, Spada F, Harrison IP. Skin Cleansing without or with Compromise: Soaps and Syndets. Molecules. 2022; 27(6).
    CrossRefPubMed
  73. Pazdrowski J, Dańczak-Pazdrowska A, Polańska A, et al. An ultrasonographic monitoring of skin condition in patients receiving radiotherapy for head and neck cancers. Skin Res Technol. 2019; 25(6): 857–861.
    CrossRefPubMed
  74. Cardona ID, Stillman L, Jain N. Does bathing frequency matter in pediatric atopic dermatitis? Ann Allergy Asthma Immunol. 2016; 117(1): 9–13.
    CrossRefPubMed
  75. Wollenberg A, Kinberger M, Arents B, et al. European guideline (EuroGuiDerm) on atopic eczema - part II: non-systemic treatments and treatment recommendations for special AE patient populations. J Eur Acad Dermatol Venereol. 2022; 36(11): 1904–1926.
    CrossRefPubMed
  76. Hymes SR, Strom EA, Fife C. Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006. J Am Acad Dermatol. 2006; 54(1): 28–46.
    CrossRefPubMed
  77. Chan DC, Wong HC, Riad MA, et al. Prevention of radiation dermatitis with skin hygiene and washing: a systematic review and meta-analysis. Support Care Cancer. 2023; 31(5): 294.
    CrossRefPubMed
  78. Westbury C, Hines F, Hawkes E, et al. Advice on hair and scalp care during cranial radiotherapy: a prospective randomized trial. Radiother Oncol. 2000; 54(2): 109–116.
    CrossRefPubMed
  79. Moncrieff G, Cork M, Lawton S, et al. Use of emollients in dry-skin conditions: consensus statement. Clin Exp Dermatol. 2013; 38(3): 231–8; quiz 238.
    CrossRefPubMed
  80. Elias PM, Wakefield JS, Man MQ. Moisturizers versus Current and Next-Generation Barrier Repair Therapy for the Management of Atopic Dermatitis. Skin Pharmacol Physiol. 2019; 32(1): 1–7.
    CrossRefPubMed
  81. Ramadan M, Hetta HF, Saleh MM, et al. Alterations in skin microbiome mediated by radiotherapy and their potential roles in the prognosis of radiotherapy-induced dermatitis: a pilot study. Sci Rep. 2021; 11(1): 5179.
    CrossRefPubMed
  82. Harris-Tryon TA, Grice EA. Microbiota and maintenance of skin barrier function. Science. 2022; 376(6596): 940–945.
    CrossRefPubMed
  83. Kost Y, Rzepecki AK, Deutsch A, et al. Association of Staphylococcus aureus Colonization With Severity of Acute Radiation Dermatitis in Patients With Breast or Head and Neck Cancer. JAMA Oncol. 2023; 9(7): 962–965.
    CrossRefPubMed
  84. Wang X, Shi XD, Li LF, et al. Classification and possible bacterial infection in outpatients with eczema and dermatitis in China: A cross-sectional and multicenter study. Medicine (Baltimore). 2017; 96(35): e7955.
    CrossRefPubMed
  85. Kost Y, Deutsch A, Mieczkowska K, et al. Bacterial Decolonization for Prevention of Radiation Dermatitis: A Randomized Clinical Trial. JAMA Oncol. 2023; 9(7): 940–945.
    CrossRefPubMed
  86. Hamann D, Hamann C. Regarding "Risks and benefits of using chlorhexidine gluconate in handwashing: a systematic literature review". Am J Infect Control. 2019; 47(12): 1524.
    CrossRefPubMed
  87. García-Valdivia M, Quiñones-Vico MI, Ortega-Llamas L, et al. Cytotoxicity, Epidermal Barrier Function and Cytokine Evaluation after Antiseptic Treatment in Bioengineered Autologous Skin Substitute. Biomedicines. 2022; 10(6).
    CrossRefPubMed
  88. Ferreira EB, Ciol MA, de Meneses AG, et al. Chamomile Gel versus Urea Cream to Prevent Acute Radiation Dermatitis in Head and Neck Cancer Patients: Results from a Preliminary Clinical Trial. Integr Cancer Ther. 2020; 19: 1534735420962174.
    CrossRefPubMed
  89. Menêses AG, Ferreira EB, Bontempo Pd, et al. Use of Chamomile Infusion to Mitigate Radiotherapy-Induced Dry Desquamation in Head and Neck Cancer Patients. Integr Cancer Ther. 2022; 21: 15347354221105491.
    CrossRefPubMed
  90. Avonto C, Rua D, Lasonkar PB, et al. Identification of a compound isolated from German chamomile (Matricaria chamomilla) with dermal sensitization potential. Toxicol Appl Pharmacol. 2017; 318: 16–22.
    CrossRefPubMed
  91. Iacovelli NA, Torrente Y, Ciuffreda A, et al. Topical treatment of radiation-induced dermatitis: current issues and potential solutions. Drugs Context. 2020; 9.
    CrossRefPubMed
  92. Dinkloh A, Worm M, Geier J, et al. Contact sensitization in patients with suspected cosmetic intolerance: results of the IVDK 2006-2011. J Eur Acad Dermatol Venereol. 2015; 29(6): 1071–1081.
    CrossRefPubMed
  93. Narbutt J, Wolska H, Kaszuba A, et al. Photoprotection. Recommendations of the Polish Dermatological Society. Part 2: Sunscreen use. Dermatology Review/Przegląd Dermatologiczny. 2018; 105(1): 30–40.
    CrossRef
  94. Ginex PK, Backler C, Croson E, et al. Radiodermatitis in Patients With Cancer: Systematic Review and Meta-Analysis. Oncol Nurs Forum. 2020; 47(6): E225–E236.
    CrossRefPubMed
  95. Zasadziński K, Spałek MJ, Rutkowski P. Modern Dressings in Prevention and Therapy of Acute and Chronic Radiation Dermatitis-A Literature Review. Pharmaceutics. 2022; 14(6).
    CrossRefPubMed
  96. Rosenthal A, Israilevich R, Moy R. Management of acute radiation dermatitis: A review of the literature and proposal for treatment algorithm. J Am Acad Dermatol. 2019; 81(2): 558–567.
    CrossRefPubMed
  97. Meyer F, Fortin A, Wang CS, et al. Predictors of severe acute and late toxicities in patients with localized head-and-neck cancer treated with radiation therapy. Int J Radiat Oncol Biol Phys. 2012; 82(4): 1454–1462.
    CrossRefPubMed
  98. Gönülal M, Güzelöz Z. Assessment of Acute and Chronic Radiodermatitis of Female Patients with Breast Cancer: The Impact of Radiotherapy and Patient Related Factors. J Turk Acad Dermatol. 2021; 15(1): 8–13.
    CrossRef
  99. Hergesell K, Paraskevopoulou A, Opálka L, et al. The effect of long-term cigarette smoking on selected skin barrier proteins and lipids. Sci Rep. 2023; 13(1): 11572.
    CrossRefPubMed
  100. Zhu T, Yang S, Mauro TM, et al. Association of Epidermal Biophysical Properties with Obesity and Its Implications. Skin Pharmacol Physiol. 2023; 36(4): 165–173.
    CrossRefPubMed
  101. Rajaganapathy BR, Janicki JJ, Levanovich P, et al. Intravesical Liposomal Tacrolimus Protects against Radiation Cystitis Induced by 3-Beam Targeted Bladder Radiation. J Urol. 2015; 194(2): 578–584.
    CrossRefPubMed
  102. Dähnhardt-Pfeiffer S, Dähnhardt D, Buchner M, et al. Comparison of effects of tacrolimus ointment and mometasone furoate cream on the epidermal barrier of patients with atopic dermatitis. J Dtsch Dermatol Ges. 2013; 11(5): 437–443.
    CrossRefPubMed
  103. Chittock J, Brown K, Cork MJ, et al. Comparing the Effect of a Twice-weekly Tacrolimus and Betamethasone Valerate Dose on the Subclinical Epidermal Barrier Defect in Atopic Dermatitis. Acta Derm Venereol. 2015; 95(6): 653–658.
    CrossRefPubMed
  104. Asgari MM, Tsai AL, Avalos L, et al. Association Between Topical Calcineurin Inhibitor Use and Keratinocyte Carcinoma Risk Among Adults With Atopic Dermatitis. JAMA Dermatol. 2020; 156(10): 1066–1073.
    CrossRefPubMed
  105. Lam M, Zhu JW, Tadrous M, et al. Association Between Topical Calcineurin Inhibitor Use and Risk of Cancer, Including Lymphoma, Keratinocyte Carcinoma, and Melanoma: A Systematic Review and Meta-analysis. JAMA Dermatol. 2021; 157(5): 549–558.
    CrossRefPubMed
  106. Robijns J, Aquilano M, Banerjee S, et al. Barrier Films and Dressings for the Prevention of Acute Radiation Dermatitis: A Systematic Review and Meta-Analysis. Support Care Cancer. 2023; 31(4): 219.
    CrossRefPubMed
  107. Gupta S, Andersen C, Black J, et al. Management of Chronic Wounds: Diagnosis, Preparation, Treatment, and Follow-up. Wounds. 2017; 29(9): S19–S36.
    PubMed
  108. Aziz Z, Abu SF, Chong NJ. A systematic review of silver-containing dressings and topical silver agents (used with dressings) for burn wounds. Burns. 2012; 38(3): 307–318.
    CrossRefPubMed
  109. Kramer A, Dissemond J, Kim S, et al. Consensus on Wound Antisepsis: Update 2018. Skin Pharmacol Physiol. 2018; 31(1): 28–58.
    CrossRefPubMed
  110. Jenerowicz D, Jakubowicz O, Polańska A, et al. Photosensitivity to selected topical nonsteroidal anti-inflammatory drugs preparations – a review of literature data and author’s own experience. Centr Eur J Immunol. 2011; 36: 197–203.
  111. Kowalska J, Rok J, Rzepka Z, et al. Drug-Induced Photosensitivity-From Light and Chemistry to Biological Reactions and Clinical Symptoms. Pharmaceuticals (Basel). 2021; 14(8).
    CrossRefPubMed
  112. Gobbo M, Rico V, Marta GN, et al. Photobiomodulation therapy for the prevention of acute radiation dermatitis: a systematic review and meta-analysis. Support Care Cancer. 2023; 31(4): 227.
    CrossRefPubMed
  113. Dörr W, Herrmann T. Study Group. Efficacy of Wobe-Mugos E for reduction of oral mucositis after radiotherapy : results of a prospective, randomized, placebo-controlled, triple-blind phase III multicenter study. Strahlenther Onkol. 2007; 183(3): 121–127.
    CrossRefPubMed
  114. Chan RJ, Webster J, Chung B, et al. Prevention and treatment of acute radiation-induced skin reactions: a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2014; 14: 53.
    CrossRefPubMed
  115. Menêses AG, Reis PE, Guerra EN, et al. Use of trolamine to prevent and treat acute radiation dermatitis: a systematic review and meta-analysis. Rev Lat Am Enfermagem. 2018; 26: e2929.
    CrossRefPubMed
  116. Wilson BN, Shah R, Menzer C, et al. Consensus on the clinical management of chronic radiation dermatitis and radiation fibrosis: a Delphi survey. Br J Dermatol. 2022; 187(6): 1054–1056.
    CrossRefPubMed
  117. Borrelli MR, Shen AH, Lee GK, et al. Radiation-Induced Skin Fibrosis: Pathogenesis, Current Treatment Options, and Emerging Therapeutics. Ann Plast Surg. 2019; 83(4S Suppl 1): S59–S64.
    CrossRefPubMed
  118. Perkins JL, Liu Y, Mitby PA, et al. Nonmelanoma skin cancer in survivors of childhood and adolescent cancer: a report from the childhood cancer survivor study. J Clin Oncol. 2005; 23(16): 3733–3741.
    CrossRefPubMed
  119. Ron E, Modan B, Preston D, et al. Radiation-Induced Skin Carcinomas of the Head and Neck. Radiat Res. 1991; 125(3): 318.
    CrossRef
  120. Greenwald E, Gorcey L, Lucey P, et al. Importance of skin cancer screening after radiation therapy. t 1;74:pAB199-AB199 doi. J Am Acad Dermatol. 2016; Suppl 1(74): AB199.
    CrossRef
  121. Chen F, Yang SF, Chen CH, et al. Secondary basal cell carcinoma of scalp after radiotherapy: A case report. Medicine (Baltimore). 2018; 97(36): e12170.
    CrossRefPubMed

About cookies

Necessary cookies

Allways active

These cookies are necessary for the proper display and operation of the website. Blocking them may cause the website to malfunction.

Analytical cookies

As part of our website, we use analytical tools, such as Google Analytics, that allow us to verify website traffic. These tools may require the use of cookies.

Community cookies

These are cookies associated with the social networks we use. Accepting them will allow us to associate your visit to the site with our social media profiles.

Marketing cookies

These are cookies responsible for carrying out advertising and marketing activities - consenting to their use will allow us to target you with advertisements based on your previous activities within our website.

Copyright © 2023 Via Medica Regulations Cookie policy Privacy policy Legal Notice