Strahlentherapie und Onkologie

, Volume 189, Issue 11, pp 977–979 | Cite as

Blisters—an unusual effect during radiotherapy

  • U. Höller
  • T. Schubert
  • V. Budach
  • U. Trefzer
  • M. Beyer
Case study

Abstract

The skin reaction to radiation is regularly monitored in order to detect enhanced radiosensitivity of the patient, unexpected interactions (e.g. with drugs) or any inadvertent overdosage. It is important to distinguish secondary disease from radiation reaction to provide adequate treatment and to avoid unnecessary discontinuation of radiotherapy. A case of bullous eruption or blisters during radiotherapy of the breast is presented. Differential diagnoses bullous pemphigoid, pemphigus vulgaris, and bullous impetigo are discussed and treatment described.

Keywords

Breast neoplasms Radiation acute effect Skin toxicity Pemphigus Impetigo 

Bullae – eine ungewöhnliche Hautreaktion während der Strahlentherapie

Zusammenfassung

Die Hautreaktion wird während der Strahlentherapie kontinuierlich überwacht, um rechtzeitig eine erhöhte Strahlenempfindlichkeit der Patientin/des Patienten, eventuelle unerwartete Interaktionen mit Begleitmedikation oder eine unbemerkte Überdosierung zu erkennen. Zweiterkrankungen, die nicht Strahlentherapie-assoziiert sind, sollten von radiogenen Reaktionen differenziert werden, um sie adäquat behandeln zu können. Bullae sind nicht typisch für die akute Radiodermatitis. Die Differenzialdiagnosen bullöses Pemphigoid, Pemphigus vulgaris und bullöse Impetigo sowie deren Therapie werden diskutiert.

Schlüsselwörter

Mammakarzinom Strahlenreaktion Hauttoxizität Pemphigus Impetigo 

Notes

Compliance with ethical guidelines

Conflict of interest. U. Hoeller, T. Schubert, V. Budach, U. Trefzer, and M. Beyer state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

References

  1. 1.
    Aguado L, Marquina M, Pretel M et al (2009) Lesions of pemphigus vulgaris on irradiated skin. Clin Exp Dermatol 34:e148–e150PubMedCrossRefGoogle Scholar
  2. 2.
    Andreassen CN, Alsner J, Overgaard J (2002) Does variability in normal tissue reactions after radiotherapy have a genetic basis—where and how to look for it? Radiother Oncol 64:131–140PubMedCrossRefGoogle Scholar
  3. 3.
    Badri T, Hammami H, Lachkham A et al (2011) Radiotherapy-induced pemphigus vulgaris with autoantibodies targeting a 110 kDa epidermal antigen. Int J Dermatol 50:1475–1479PubMedCrossRefGoogle Scholar
  4. 4.
    Cabrera-Rodriguez JJ, Munoz-Garcia JL, Quiros Rivero J et al (2011) Radio-induced bullous pemphigoid. Clin Transl Oncol12:66–68Google Scholar
  5. 5.
    Geria AN, Schwartz RA (2010) Impetigo update: new challenges in the era of methicillin resistance. Cutis 85:65–70PubMedGoogle Scholar
  6. 6.
    Hoeller U, Borgmann K, Bonacker M et al (2003) Individual radiosensitivity measured with lymphocytes may be used to predict the risk of fibrosis after radiotherapy for breast cancer. Radiother Oncol 69:137–144PubMedCrossRefGoogle Scholar
  7. 7.
    Melani L, Giomi B, Antiga E et al (2005) Radiation therapy as a trigger factor for initially localized bullous pemphigoid. Breast J 11:485–486PubMedCrossRefGoogle Scholar
  8. 8.
    Mul VE, Geest AJ van, Pijls-Johannesma MC et al (2007) Radiation-induced bullous pemphigoid: a systematic review of an unusual radiation side effect. Radiother Oncol 82:5–9PubMedCrossRefGoogle Scholar
  9. 9.
    NCI (2010) NCI Common Terminology Criteria for Adverse Events (CTCAE) v.4 http://ctep.cancer.gov. Accessed 05 Sept 2013Google Scholar
  10. 10.
    Pommier P, Gomez F, Sunyach MP et al (2004) Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol 22:1447–1453PubMedCrossRefGoogle Scholar
  11. 11.
    Stanley JR, Amagai M (2006) Pemphigus, bullous impetigo, and the staphylococcal scalded-skin syndrome. N Engl J Med 355:1800–1810PubMedCrossRefGoogle Scholar
  12. 12.
    Tucker SL, Turesson I, Thames HD (1992) Evidence for individual differences in the radiosensitivity of human skin. Eur J Cancer 28A:1783–1791PubMedCrossRefGoogle Scholar

Copyright information

© Springer Heidelberg Berlin 2013

Authors and Affiliations

  • U. Höller
    • 1
  • T. Schubert
    • 1
  • V. Budach
    • 1
  • U. Trefzer
    • 2
  • M. Beyer
    • 2
  1. 1.Radiation Oncology and Radiotherapy, StrahlentherapieCharité Universitätsmedizin Berlin, Ambulantes Gesundheitscentrum Charité MitteBerlinGermany
  2. 2.DermatologyCharité Universitätsmedizin BerlinBerlinGermany

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