Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Cosmet Dermatol. 2021 Sep;20(9):2880-2886. doi: 10.1111/jocd.14308. Epub 2021 Jul 1.
Postoperative radiation is one of the most effective treatments for keloid. Radiation-induced hyperpigmentation is, however, a concern for both patients and dermatologists.
To identify clinical features and risk factors of superficial X-ray-induced hyperpigmentation in postoperative keloid radiotherapy.
PATIENTS/METHODS: From November 2019 to November 2020, 70 keloids in 55 patients were treated with superficial X-ray after surgery. Patient data and treatment-related parameters were collected. Follow-up photographs were taken one month after radiotherapy. Three independent dermatologists assessed photographs for pigmentation. The clinical characteristics and severity of pigmentation were summarized. Logistic regression was used to analyze the risk factors associated with occurrence and severity of hyperpigmentation.
The pigmentation was a well-defined rectangular brown macule consistent with the unprotected area that involves normal skin, and 82.9% of keloids displayed pigmentation induced by superficial X-ray at one month after treatment. All keloids of trunk appeared to be mild-to-moderately hyperpigmented (100%); 92.89% of limb keloids displayed mainly severe pigmentation. Keloid location was an independent risk factor for the incidence and severity of pigmentation. Longer incision length was also predictive of increased hyperpigmentation severity.
Superficial X-ray-induced hyperpigmentation was common and severe in postoperative keloid radiotherapy. The incidence and severity of pigmentation can be predicted by the location and incision length of the keloid.
术后放射治疗是治疗瘢痕疙瘩的最有效方法之一。然而，放射性色素沉着是患者和皮肤科医生共同关注的问题。
明确术后瘢痕疙瘩放射治疗中浅层 X 射线诱导的色素沉着的临床特征和危险因素。
患者/方法：2019 年 11 月至 2020 年 11 月，55 例患者 70 处瘢痕疙瘩术后接受浅层 X 射线治疗。收集患者资料和治疗相关参数。放射治疗后 1 个月拍摄随访照片。3 位独立皮肤科医生对照片进行色素沉着评估。总结色素沉着的临床特征和严重程度。采用 logistic 回归分析与色素沉着发生和严重程度相关的危险因素。
色素沉着为边界清楚的长方形棕色斑片，与未受保护区域一致，累及正常皮肤，治疗后 1 个月 82.9%的瘢痕疙瘩出现浅层 X 射线诱导的色素沉着。所有躯干瘢痕疙瘩均表现为轻至中度色素沉着（100%）；92.89%的肢体瘢痕疙瘩主要表现为重度色素沉着。瘢痕疙瘩位置是色素沉着发生和严重程度的独立危险因素。切口长度越长，色素沉着严重程度越高。
术后瘢痕疙瘩放射治疗中浅层 X 射线诱导的色素沉着很常见且严重。色素沉着的发生率和严重程度可以通过瘢痕疙瘩的位置和切口长度来预测。
