Accidental exposure to ionising radiation may occur during such catastrophic events as
the Chernobyl accident in 1986 or for days and weeks as in Goiania in 1987 and in the
military camp during the training of soldiers in Lilo/Georgia in 1997 as well as in medical
institutions. The cutaneous symptoms after radiation exposure are based on a combination
of inflammatory processes and alteration of cellular proliferation as a result of a
specific pattern of transcriptionally activated proinflammatoric cytokines and growth
factors. They follow a time course consisting of prodromal erythema, manifestation,
chronic stage, late stage and they are referred to as Cutaneous Radiation Syndrome.
The time course depends on several factors such as the applied radiation dose, radiation
quality, individual radiation sensitivity, the extent of contamination and absorption
and volume of the skin. For diagnostics of the cutaneous radiation syndrome the following
procedures are used: 7.5 MHz to 20 MHz-B-scan-sonography, thermography, capillary
microscopy, profilometry, nuclear magnetic resonance imaging, bone scintigraphy and
histology. Based on the results of experimental and clinical research of the last
years pharmacotherapy of the cutaneous radiation syndrome includes topic or systemic
application of corticosteroids, gamma-interferon, pentoxifylline and vitamin E and
superoxide dismutase. The treatment depends on the stage of the cutaneous radiation
syndrome. Due to the complexity of the clinical manifestations of radiation disease
in most patients an interdisciplinary treatment in specialised centres is necessary.
Dermatologists are asked to perform in most cases life-long therapy and follow-up of
the patients.