Cappelli Louis, Poiset Spencer, Greenberger Benjamin, Bar-Ad Voichita
Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, USA.
Radiation Oncology, University of Pittsburgh Medical Center, Hamot, USA.
Cureus. 2022 Apr 4;14(4):e23815. doi: 10.7759/cureus.23815. eCollection 2022 Apr.
Thermoplastic masks are commonly used in radiation therapy to immobilize a patient's head and neck during treatment. They are primarily composed of non-toxic polyester compounds that can be manipulated with heat to mold the shape of a patient's head and neck. There is little previously reported evidence of these masks causing allergic contact dermatitis. We present a case of a 44-year-old female with a history of squamous cell carcinoma of the right tonsil with multiple enlarged lymph nodes following surgical excision of the right tonsillar mass and ipsilateral neck dissection elected to undergo adjuvant radiation therapy with volumetric modulated arc therapy (VMAT) technique without concurrent chemotherapy. A thermoplastic mask was issued prior to radiation therapy. Following the mask fitting, the patient developed an allergic contact dermatitis reaction of the head and neck in areas covered by the mask. Her symptoms worsened with continued use of the thermoplastic mask and radiation therapy. As the patient continued and eventually finished the radiation treatment regimen, the dermatologic symptoms failed to respond to topical facial moisturizer and steroid treatment. The contact dermatitis reaction did not completely dissipate until about three months following completion of radiation therapy and contact with the thermoplastic mask. Thermoplastic masks are not known to cause an allergic contact dermatitis reaction. There is only one other reported case documented in the literature. Such reactions can alter the course of radiation therapy if symptoms are severe enough to disrupt treatment or if they cause worsening of the radiation dermatitis. Allergic contact dermatitis to thermoplastic masks should be well documented in the future to better understand the cause and possible risk factors related to the reaction.
热塑性面罩在放射治疗中常用于在治疗期间固定患者的头部和颈部。它们主要由无毒的聚酯化合物组成，这种化合物可通过加热进行塑形，以贴合患者头部和颈部的形状。此前几乎没有关于这些面罩导致过敏性接触性皮炎的报道证据。我们报告一例44岁女性病例，该患者有右侧扁桃体鳞状细胞癌病史，在右侧扁桃体肿物手术切除及同侧颈部清扫术后出现多个肿大淋巴结，选择接受容积调强弧形放疗（VMAT）技术的辅助放疗，未同时进行化疗。在放疗前发放了一个热塑性面罩。面罩佩戴后，患者在面罩覆盖区域出现了头颈部过敏性接触性皮炎反应。随着热塑性面罩的持续使用和放疗，她的症状加重。由于患者继续并最终完成了放疗疗程，皮肤症状对面部局部保湿剂和类固醇治疗无反应。直到放疗结束且不再接触热塑性面罩约三个月后，接触性皮炎反应才完全消退。热塑性面罩通常不会引起过敏性接触性皮炎反应。文献中仅另有一例报道。如果症状严重到足以干扰治疗或导致放射性皮炎加重，此类反应可能会改变放疗进程。未来应充分记录热塑性面罩引起的过敏性接触性皮炎，以便更好地了解其病因及与该反应相关的可能风险因素。
