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Seminars in Oncology Apr 2022Radiation recall dermatitis (RRD) is a skin reaction limited to an area of prior radiation triggered by the subsequent introduction of systemic therapy. To characterize... (Review)
Review
PURPOSE/OBJECTIVES
Radiation recall dermatitis (RRD) is a skin reaction limited to an area of prior radiation triggered by the subsequent introduction of systemic therapy. To characterize RRD, we conducted a literature search, summarized RRD features, and compared the most common drug classes implicated in this phenomenon.
MATERIALS/METHODS
PubMed, Embase, Scopus, Web of Science, and Cochrane DBSR databases were queried through July 1, 2019 using key words: radiation recall, RRD, and radiodermatitis (limited to humans and English language). Studies included case reports in which patients treated with radiotherapy were initiated on a new line of systemic therapy and subsequently developed a skin reaction in the irradiated area. RRD cases were organized by whether RRD occurred after a single drug or multiple drug administration.
RESULTS
One-hundred fifteen studies representing 129 RRD cases (96 single-drug RRD, 33 multi-drug) were included. Sixty-three drugs were associated with RRD. Docetaxel (22) and gemcitabine (18) were the two drugs most commonly associated with RRD. Breast cancer (69 cases) was the most commonly associated tumor type. For single-drug RRD, the median radiotherapy dose was 45.0 Gy (range, 30.0-63.2 Gy). The median time from radiotherapy to drug exposure, time from drug exposure to RRD and time to significant improvement was 8 weeks (range, 2-132 weeks), 5 days (range, 2-56 days), and 14 days (range, 7-49 days), respectively. Variables significantly associated with grade ≥2 toxicity were docetaxel (P = 0.04) and non-antifolate antimetabolite (P = 0.05). The only variable significantly associated with grade ≥3 toxicity was capecitabine (P = 0.04).
CONCLUSIONS
RRD is a complex toxicity that can occur after a wide range of radiotherapy doses and many different systemic agents. Most commonly, it presents in patients diagnosed with breast cancer and after administration of a taxane or antimetabolite medication. RRD treatment generally consists of corticosteroids with consideration of antibiotics if superinfection is suspected. Drug re-challenge may be considered after RRD if the initial reaction was of mild intensity.
Topics: Antimetabolites; Breast Neoplasms; Docetaxel; Female; Humans; Radiodermatitis
PubMed: 35585004
DOI: 10.1053/j.seminoncol.2022.04.001 -
International Journal of Dermatology Sep 2004
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The Lancet. Oncology Apr 2023Acute radiation dermatitis is a frequent adverse effect of radiotherapy, but standardisation of care for acute radiation dermatitis is lacking. Due to the conflicting... (Review)
Review
Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidelines for the prevention and management of acute radiation dermatitis: international Delphi consensus-based recommendations.
Acute radiation dermatitis is a frequent adverse effect of radiotherapy, but standardisation of care for acute radiation dermatitis is lacking. Due to the conflicting evidence and variability in current guidelines, a four-round Delphi consensus process was used to compile opinions of 42 international experts on care for people with acute radiation dermatitis on the basis of the evidence in existing medical literature. Interventions for acute radiation dermatitis prevention or management that reached at least 75% consensus were recommended for clinical use. Six interventions could be recommended for the prevention of acute radiation dermatitis: photobiomodulation therapy and Mepitel film in people with breast cancer, Hydrofilm, mometasone, betamethasone, and olive oil. Mepilex Lite dressings were recommended for the management of acute radiation dermatitis. Most interventions were not recommended due to insufficient evidence, conflicting evidence, or lack of consensus to support use, suggesting a need for further research. Clinicians can consider implementing recommended interventions in their practice to prevent and manage acute radiation dermatitis until additional evidence becomes available.
Topics: Female; Humans; Breast Neoplasms; Consensus; Delphi Technique; Radiodermatitis
PubMed: 36990615
DOI: 10.1016/S1470-2045(23)00067-0 -
Journal of Investigative Medicine High... 2023Radiation recall dermatitis is an inflammatory reaction of the skin that may infrequently occur in areas of the skin that have been previously treated with radiation... (Review)
Review
Radiation recall dermatitis is an inflammatory reaction of the skin that may infrequently occur in areas of the skin that have been previously treated with radiation therapy. This is thought to be due to a triggering agent administered after radiation therapy which leads to an acute inflammatory reaction, manifesting as a skin rash. We present the case of a 58-year-old male with recurrent invasive squamous cell carcinoma of the tongue, previously treated with chemotherapy and radiation therapy, who presented with progression of his disease. He was treated with pembrolizumab and subsequently developed a new-onset facial rash over the previously treated radiation field. The distribution of the rash was suggestive of radiation recall dermatitis. A biopsy showed dermal necrosis without evidence of dermatitis, vasculitis, or infectious process. This case highlights the incidence of a rare complication of immune checkpoint inhibitor therapy and emphasizes the need for careful monitoring for radiation recall dermatitis.
Topics: Male; Humans; Middle Aged; Radiodermatitis; Neoplasm Recurrence, Local; Antibodies, Monoclonal, Humanized; Carcinoma, Squamous Cell; Exanthema
PubMed: 37096743
DOI: 10.1177/23247096231168114 -
Journal Der Deutschen Dermatologischen... Nov 2023
Topics: Humans; Radiodermatitis; Furans; Ketones; Antineoplastic Agents
PubMed: 37548287
DOI: 10.1111/ddg.15200 -
Head & Neck Aug 2020Radiation recall dermatitis (RRD) is an acute inflammatory skin reaction occurring in a skin area previously exposed to radiotherapy and triggered by subsequent intake...
BACKGROUND
Radiation recall dermatitis (RRD) is an acute inflammatory skin reaction occurring in a skin area previously exposed to radiotherapy and triggered by subsequent intake of a drug, most commonly a chemotherapeutic agent. RRD secondary to antibiotics has also been reported but is a rare phenomenon overall and there are no reports of RRD in association with ceftriaxone exposure.
METHODS
We report on a 59-year-old patient who had received radiotherapy to the neck bilaterally and who developed RRD 6 months later after a single dose of intramuscular ceftriaxone.
RESULTS
The patient's rash resolved without further intervention over the ensuing 2 days following administration of a single dose of ceftriaxone.
CONCLUSION
This case illustrates that while RRD secondary to antibiotic exposure is rare, it is part of the differential diagnosis to be considered for acute dermatitis when there is a past history of radiotherapy to the same skin area.
Topics: Anti-Bacterial Agents; Antineoplastic Agents; Ceftriaxone; Humans; Middle Aged; Radiodermatitis
PubMed: 32270528
DOI: 10.1002/hed.26154 -
Anais Brasileiros de Dermatologia 2023
Topics: Humans; Radiodermatitis; Ibuprofen
PubMed: 36967273
DOI: 10.1016/j.abd.2021.08.017 -
Breast (Edinburgh, Scotland) Oct 2022and purpose: Radiation recall dermatitis is an adverse event predominantly due to systemic therapy administration after a previous radiation therapy course. Few case... (Observational Study)
Observational Study
BACKGROUND
and purpose: Radiation recall dermatitis is an adverse event predominantly due to systemic therapy administration after a previous radiation therapy course. Few case reports describe radiation recall dermatitis in breast cancer patients treated with postoperative radiation therapy following COVID-19 vaccination. In this study we investigated the incidence and severity of radiation recall dermatitis after COVID-19 vaccination in irradiated breast cancer patients.
METHODS
Patients that received at least one COVID-19 vaccination dose during the year after the end of postoperative breast radiation therapy were included in this observational monocentric study. Local symptoms occurring inside the radiation field after vaccination were patient-reported and scored according to the PRO-CTCAE questionnaire. Descriptive data of radiation recall dermatitis incidence and severity, and potential risk factors were evaluated.
RESULTS
A cohort of 361 patients with 756 administered COVID-19 vaccinations was analyzed. Breast symptoms were reported by 7.5% of patients, while radiation recall dermatitis was considered for 5.5%. The incidence of radiation recall dermatitis per single dose of vaccine was 2.6%, with a higher risk for the first dose compared to the second/third (4.4% vs 1%, p = 0.003), especially when administered within the first month after the end of irradiation (12.5% vs 2.2%, p = 0.0004). Local symptoms were generally self-limited and a few cases required anti-inflammatory drugs.
CONCLUSIONS
Radiation recall dermatitis is an uncommon but not rare phenomenon in breast cancer patients that received COVID-19 vaccination within one year after breast irradiation. However, symptoms severity were generally low/mild and reversible. These findings can be useful for patient counseling.
Topics: Breast Neoplasms; COVID-19; COVID-19 Vaccines; Female; Humans; Radiodermatitis; Vaccination
PubMed: 35816893
DOI: 10.1016/j.breast.2022.06.008 -
Aging Nov 2020Radiation-induced skin injury (RSI) refers to a frequently occurring complication of radiation therapy. Nearly 90% of patients having received radiation therapy... (Review)
Review
Radiation-induced skin injury (RSI) refers to a frequently occurring complication of radiation therapy. Nearly 90% of patients having received radiation therapy underwent moderate-to-severe skin reactions, severely reducing patients' quality of life and adversely affecting their disease treatment. No gold standard has been formulated for RSIs. In the present study, the mechanism of RSI and topical medications was discussed. Besides, this study can be referenced for clinicians to treat RSIs to guide subsequent clinical medicine.
Topics: Administration, Cutaneous; Animals; Apoptosis; Dermatologic Agents; Fibrosis; Humans; Occupational Exposure; Radiation Exposure; Radiodermatitis; Radiotherapy; Severity of Illness Index; Skin; Treatment Outcome
PubMed: 33202382
DOI: 10.18632/aging.103932 -
Dermatology Online Journal Feb 2017Radiation recall dermatitis (RRD) canpresent days to years after radiation exposure andis most commonly caused by chemotherapy drugs,with tamoxifen-induced radiation...
BACKGROUND
Radiation recall dermatitis (RRD) canpresent days to years after radiation exposure andis most commonly caused by chemotherapy drugs,with tamoxifen-induced radiation recall dermatitisbeing exceptionally rare.
PURPOSE
To report a newcase of tamoxifen-induced radiation recall dermatitisafter 4.5 years of tamoxifen exposure, making this thelongest time of onset to RRD after tamoxifen initiation.
MATERIALS AND METHODS
The case of a woman withtamoxifen-induced RRD is presented. Using PubMedand Google Scholar, the terms tamoxifen, radiation,recall, dermatitis were searched. Relevant citationswere utilized and discussed.
RESULTS
An adult womanwith history of inflammatory breast carcinomadeveloped an erythematous, scaly, tender plaquelocalized to previously irradiated skin of the left chestafter more than four years of tamoxifen therapy. Thepatient was diagnosed with RRD and was treated withtopical triamcinolone 0.1% cream twice daily to theaffected areas. The patient experienced subsequentrapid improvement despite continuation of tamoxifentreatment. Biopsy revealed changes consistent withradiation dermatitis with no evidence of malignancy.
CONCLUSION
Radiation recall dermatitis can havesignificant impact on affected patients and can posea diagnostic dilemma for clinicians who may mistakeRRD for infection or recurrence of malignancy. It isimportant to be familiar with the presenting signs andsymptoms of this entity so that affected patients canreceive timely and appropriate therapy.
Topics: Administration, Cutaneous; Antineoplastic Agents, Hormonal; Carcinoma; Female; Glucocorticoids; Humans; Inflammatory Breast Neoplasms; Mastectomy; Middle Aged; Radiodermatitis; Radiotherapy; Tamoxifen; Triamcinolone
PubMed: 28329490
DOI: No ID Found