Hill A, Hanson M, Bogle MA, Duvic M, et al.
American journal of clinical oncology. Date of publication 2004 Aug 1;volume 27(4):361-3.
1. Am J Clin Oncol. 2004 Aug;27(4):361-3.
Severe radiation dermatitis is related to Staphylococcus aureus.
Hill A(1), Hanson M, Bogle MA, Duvic M.
Author information:
(1)Baylor College of Medicine, Department of Dermatology, The University of Texas
Health Science Center, Houston, Texas, USA.
Acute radiation dermatitis commonly occurs following local radiation therapy for
various cancers and, when severe, may necessitate disruption of treatment.
Intense inflammatory reaction may result in a breakdown of the skin's barrier
function and accompanying bacterial colonization. Bacterial superantigens may
exacerbate inflammation through activation of T-cells and subsequent cytokine
release. We report six cases of severe radiation dermatitis in cancer patients.
Four of the six grew pathogenic bacteria, and three had psoriasiform or
eczematous reactions at distant sites. Both the radiation dermatitis and the
distant cutaneous reactions resolved rapidly on a combination of topical steroids
and oral plus topical antibiotic therapy. We suggest that staphylococcal
superinfection of acute radiodermatitis intensifies the inflammatory process and
hinders repair of the epidermal barrier. Patients with acute radiation dermatitis
should be investigated for secondary infection. We emphasize the importance of
including topical and oral antibiotic therapy in conjunction with topical
corticosteroids to eradicate infection as well as hasten repair of the skin's
barrier function. These cases are presented to call attention to the role of
Staphylococcus aureus in the pathogenesis of severe radiation dermatitis and the
need to include appropriate antibiotic therapy based on culture in the management
of acute radiation dermatitis.
PMID: 15289728 [Indexed for MEDLINE]
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