[Radiation-induced skin toxicities: prevention, treatment]

Acute and long term effects are frequent after radiotherapy. They may alter the general status and quality of life of the patients. Chronic radiodermatitis may result in ulceration and in transformation into a squamous cell carcinoma. There is a correlation of the frequency of acute dermatitis with the total dose. Chronic radiodermatitis may develop after repeated small doses of ionizing radiation for cardiac catheterization and coronary angioplasties. The other prognostic factors for the level of acute and late skin reactions are volume of tissue treated, total daily dose, fractionactions schemes ... but there are some variation in the degree of reaction in patients treated with identical radiotherapy schedules. There is a patient-to-patient variability. Several diseases as systemic sclerosis, some genetic diseases, perhaps some drugs may increase the cutaneous reactions. So both acute and chronic irradiation injury is a complex process with many regulations. Chronic fibrosis may be caused by mechanism of cell activation (and particularly fibroblasts). Cytokines e.g. transforming growth factor beta (TGF-beta) might be involved in the induction of fibrosis. Treatment use emollients. Superoxide dismutase was used as an ointment for radiofibrosis therapy and obtains a reduction of the fibrosis. In late phases plastic surgery or sometimes cryosurgery can be used.