Archive

Summer 2004, Vol. 12 No. 2

H.K. Dermatol. Venereol. Bull. (2004) 12, 71-77

Review Article

Radiation-recall dermatitis associated with cytotoxic chemotherapy

W Yeo 楊明明

Abstract
Radiation-recall dermatitis is a well-recognised phenomenon of an acute inflammatory toxicity that occurs in a previously quiescent radiation field with subsequent cytotoxic chemotherapy administration. It may occur from days to weeks, and sometimes years after the radiation therapy. The precise mechanism is unknown. One hypothesis suggests that the initial radiation therapy leads to a depletion of tissue stem cells within the irradiated field and that subsequent cytotoxic chemotherapy exposure causes a 'remembered' reaction among the remaining surviving cells. An alternative proposition suggests that radiation induces heritable mutations within surviving cells which then produce a subgroup of defective stem cells that are unable to tolerate the second insult of chemotherapy. Treatment is mainly supportive and most of the lesions will heal spontaneously. Some reports have noted that radiation recall dermatitis recurred with subsequent continual administration of the same chemotherapeutic agent, however such experience is non-universal. Preventative measures that have been employed to avoid recurrence of the condition include subsequent cytotoxic dose modification, prophylactic steroid coverage, and discontinuation of the implicated cytotoxic.