By Gary M. White, MD
An atrophic, white scar and comedones (similar to Favre-Racouchot) resulted from radiation therapy for BCC 4 years previously.
Radiation therapy may be used to treat various skin malignancies, most commonly basal cell carcinoma (BCC) and squamous cell carcinoma. Radiation therapy is often indicated for elderly, debilitated patients, patients on anticoagulation therapy, or large lesions whose surgical removal would leave a large defect.
Radiation therapy may be considered for a BCC of nearly any size. Radiation therapy is not recommended for morpheaform BCCs or those that are infiltrative where the clinical margins are difficult to discern. In such cases, the appropriate radiation therapy margins are difficult to determine.
Squamous cell carcinomas of the face, especially of the lip, ear, nose, and eyelid are particularly amenable to radiation therapy in order to reduce both functional and cosmetic defects. Both large and small lesions may be considered.
Initially, during therapy, the skin is red and inflamed. Significant crusting may occur. This acute radiation dermatitis is similar to a bad sunburn. Within weeks to months after completion of therapy, the inflammation subsides. Long term effects of radiation on the skin include alopecia, atrophy, comedones, telangiectasias and hypopigmentation.
Acute radiation dermatitis.
Hypopigmentation and alopecia after treating a BCC.
Significant yellowing of the skin.
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