Diseases Caused by Ionizing Radiation

Abstract

Ionizing radiation leads, in particular in accidental exposure scenarios with inhomogeneous partial body exposure (nuclear power plant accident contamination with nuclides or radiation sources in industry or medicine, terrorist use of “dirty bombs,” cardiac catheter examinations) to a characteristic sequence of clinical symptoms that are caused by inflammatory processes and by the radiation-induced proliferation inhibition of division-active cells, and are referred to in their entirety as cutaneous radiation syndrome. A few minutes to a few hours following exposure, a prodromal stage persisting for about 48 h occurs, with redness and itching of the affected skin areas. A few days to 4 weeks after exposure, the manifestation stage follows, which is accompanied by intense reddening, blistering, and skin necrosis, which flows into the subacute stage, characterized by vasculitis of deep dermal and subcutaneous vessels. Several months to years after exposure, late-stage epidermal atrophy and chronic progressive subcutaneous fibrosis occur, with loss of sebaceous and sweat glands and usually permanent atrophy of the hair follicles. Secondary neoplasias usually occur in the clinically inconspicuous neighboring areas of the initially affected skin site. An initial anti-inflammatory treatment (using topical and systemic steroids) may reduce the severity of the manifestation stage as well as the subsequent stages. In the chronic stage, antifibrotically effective treatments (interferon-γ, pentoxyfillin) are available. Lifelong aftercare of affected patients is necessary.