Mélanie Guesnier-Dopagne1, Louis Boyer2, Bruno Pereira3, Joël Guersen4, Pascal Motreff5, Michel D'Incan6. 1. Department of Dermatology, Estaing Hospital, CHU Clermont-Ferrand, Clermont-Auvergne University, 1 Place Lucie Aubrac, F-63003 Clermont-Ferrand Cedex 1, France; Department of Medicine, Clermont-Auvergne University, France. Electronic address: melanie.guesnier@gmail.fr. 2. Department of Medicine, Clermont-Auvergne University, France; TGI, Institut Pascal, UMR 6602, UCA/CNRS/SIGMA, Aubière, France; Department of Radiology, Gabriel Montpied Hospital, CHU Clermont-Ferrand, Clermont-Auvergne University, Clermont-Ferrand, France. 3. Department of Medicine, Clermont-Auvergne University, France; Department of Biostatistics, Clermont-Auvergne University, France. 4. Department of Radiology, Gabriel Montpied Hospital, CHU Clermont-Ferrand, Clermont-Auvergne University, Clermont-Ferrand, France. 5. Department of Medicine, Clermont-Auvergne University, France; Department of Cardiology, Gabriel Montpied Hospital, CHU Clermont-Ferrand, Clermont-Auvergne University, Clermont-Ferrand, France. 6. Department of Dermatology, Estaing Hospital, CHU Clermont-Ferrand, Clermont-Auvergne University, 1 Place Lucie Aubrac, F-63003 Clermont-Ferrand Cedex 1, France; Department of Medicine, Clermont-Auvergne University, France.
Abstract
PURPOSE: To assess the incidence and risk factors for chronic radiodermatitis after fluoroscopically guided interventions (FGIs) in high-risk patients. MATERIALS AND METHODS: Between 2010 and 2016, of 55,782 patients who underwent FGIs, 359 had a risk procedure for skin injury (maximal skin dose > 3 Gy, air kerma > 5 Gy, dose area product [DAP] > 500 Gy.cm2, or fluoroscopy time > 60 minutes). Ninety-one of these patients were examined by a dermatologist for radiodermatitis (median time after procedure, 31.2 months [95% confidence interval, 14.2-50.7]). In each case, the clinical features and topography of the skin lesions were recorded and their incidence calculated. The characteristics of the patients and of the FGIs were tested as risk factors. RESULTS: Eight patients (8.8%) had chronic radiodermatitis; 19 (20.9%) had acute radiodermatitis. Body mass index, DAP value, and air kerma were the only risk factors identified. CONCLUSIONS: This study shows that chronic radiodermatitis may be considered a frequent side effect in an at-risk population. The lesions are commonly benign, but extensive sclerosis can occur. Patients should be better informed about the side effects and offered a skin exam periodically.
PURPOSE: To assess the incidence and risk factors for chronic radiodermatitis after fluoroscopically guided interventions (FGIs) in high-risk patients. MATERIALS AND METHODS: Between 2010 and 2016, of 55,782 patients who underwent FGIs, 359 had a risk procedure for skin injury (maximal skin dose > 3 Gy, air kerma > 5 Gy, dose area product [DAP] > 500 Gy.cm2, or fluoroscopy time > 60 minutes). Ninety-one of these patients were examined by a dermatologist for radiodermatitis (median time after procedure, 31.2 months [95% confidence interval, 14.2-50.7]). In each case, the clinical features and topography of the skin lesions were recorded and their incidence calculated. The characteristics of the patients and of the FGIs were tested as risk factors. RESULTS: Eight patients (8.8%) had chronic radiodermatitis; 19 (20.9%) had acute radiodermatitis. Body mass index, DAP value, and air kerma were the only risk factors identified. CONCLUSIONS: This study shows that chronic radiodermatitis may be considered a frequent side effect in an at-risk population. The lesions are commonly benign, but extensive sclerosis can occur. Patients should be better informed about the side effects and offered a skin exam periodically.