Peter Ralf Uwe, Gottlöber Petra
Department of Dermatology, University of Ulm, Armed Forces Hospital Ulm, Ulm, Germany.
Mil Med. 2002 Feb;167(2 Suppl):110-2.
The cutaneous symptoms that appear after radiation exposure are caused by a combination of inflammatory processes and alteration of cellular proliferation as a result of a specific pattern of transcriptionally activated proinflammatory cytokines and growth factors. The symptoms follow a time course consisting of prodromal erythema, manifestation, chronic stage, and late stage; these symptoms are referred to as cutaneous radiation syndrome (CRS). The time course depends on several factors such as the applied radiation dose, radiation quality, individual radiation sensitivity, extent of contamination and absorption, and volume of skin exposed. For diagnosis of CRS, the following procedures are used: 7.5 to 20 MHz B-scan sonography, thermography, capillary microscopy, profilometry, nuclear magnetic resonance imaging, bone scintigraphy, and histology. Based on the results of previous experimental and clinical research, pharmacotherapy of CRS can include topical or systemic application of corticosteroids, gamma interferon, pentoxifylline and vitamin E, and superoxide dismutase. The treatment varies according to the stage of CRS. Due to the complexity of the clinical manifestations of radiation disease in most patients, interdisciplinary treatment at specialized centers is necessary. In most cases, dermatologists are asked to provide lifelong therapy and follow-up of the patients.
辐射暴露后出现的皮肤症状是由炎症过程以及特定模式转录激活的促炎细胞因子和生长因子导致的细胞增殖改变共同引起的。这些症状呈现出一个时间进程，包括前驱红斑期、表现期、慢性期和后期；这些症状被称为皮肤辐射综合征（CRS）。这个时间进程取决于几个因素，如所施加的辐射剂量、辐射质量、个体辐射敏感性、污染和吸收程度以及暴露皮肤的面积。对于CRS的诊断，采用以下方法：7.5至20兆赫的B超扫描、热成像、毛细血管显微镜检查、轮廓测定法、核磁共振成像、骨闪烁显像和组织学检查。根据先前的实验和临床研究结果，CRS的药物治疗可包括局部或全身应用皮质类固醇、γ干扰素、己酮可可碱、维生素E以及超氧化物歧化酶。治疗方法根据CRS的阶段而有所不同。由于大多数患者辐射病临床表现的复杂性，在专业中心进行多学科治疗是必要的。在大多数情况下，皮肤科医生需要为患者提供终身治疗和随访。
