Actinic dermatitis is an inflammation of the skin that occurs as a result of radiation exposure. Actinic dermatitis can be caused by sunlight, artificial sources of UV radiation and ionizing radiation. The clinical picture of dermatitis depends on the intensity and time of exposure to radiation on the skin. Treatment of actinic dermatitis includes the use of healing creams and remedies for the treatment of burns, infection prevention and pain management. With necrotic changes in large areas of the skin, plastic closure of the defect may be required.
ICD 10
L57.0 Actinic (photochemical) keratosis
General information
Actinic dermatitis is an inflammation of the skin that occurs as a result of radiation exposure. Actinic dermatitis can be caused by sunlight, artificial sources of UV radiation and ionizing radiation. The clinical picture of dermatitis depends on the intensity and time of exposure to radiation on the skin. Chronic actinic dermatitis can develop in farmers, welders, workers of smelters and foundries, radiologists.
Symptoms
Acute actinic dermatitis
The appearance of the first signs of acute actinic dermatitis is preceded by a latent period. For solar dermatitis, it is only a few hours, for radiation (radiation) — from 1 day to 2 months.
Acute actinic dermatitis of solar origin is characterized by redness and swelling of the skin with a burning sensation, itching or pain. Sometimes it occurs with fever, nausea, weakness and general intoxication. As a rule, solar dermatitis leads to large lamellar peeling of the skin. In some cases, serous blisters may occur on the skin, after opening which erosions are formed. With chronic solar dermatitis, open areas of the skin have a bronze hue, become dry and thickened, red plaques appear on them.
In the clinic of acute radiation dermatitis, there are 3 stages:
- The stage of redness (erythematous) is swelling, redness and soreness of the affected area of the skin. The appearance of spot hemorrhages indicates a deep lesion and an unfavorable prognosis.
- The bullous stage of radiation actinic dermatitis is characterized by increased edema, increased pain and the appearance of large blisters (up to the size of a chicken egg) with a thick tire. After opening the bubbles, wet erosions are formed, the healing of which occurs with the formation of a scar.
- The stage of necrosis can develop against the background of bullous or bypassing it. It is accompanied by a serious condition of the patient, high fever, insomnia, severe pain. Ulcers that do not heal for several months appear on the skin. When the ulcer heals, a scar is formed, any superficial injury of which leads to repeated necrosis and the formation of a trophic ulcer.
Chronic actinic dermatitis
Chronic actinic dermatitis from ionizing radiation is accompanied by atrophic processes in the skin. The skin becomes thinner, loses elasticity, becomes dry and sensitive, painful cracks appear on it. Then areas of increased keratinization (hyperkeratosis) and warty growths begin to appear. Skin lesions from artificial sources of UV radiation are similar to solar dermatitis, but are often accompanied by intoxication, keratitis and conjunctivitis.
Complications
Red plaques in chronic solar dermatitis, areas of hyperkeratosis and skin overgrowth in chronic radiation dermatitis can be the cause of skin cancer.
Treatment
Treatment of acute skin damage by solar or artificial UV rays consists in the use of cooling lotions, healing creams and means for the treatment of burns. When bubbles appear, they are pierced.
In the treatment of the first stage of radiation actinic dermatitis, corticosteroids, linetol, linol are locally used. When bubbles form, the liquid is sucked out of them and a pressure bandage is applied. When suppuration occurs, the bladder is opened and a disinfectant ointment is applied, the patient is prescribed an antibiotic. Treatment at the stage of necrosis is aimed at preventing infection, relieving pain, strengthening immunity, stimulating healing processes.
If the necrosis site is well delimited, then its surgical excision is performed. With large non—healing areas of necrosis, plastic surgery may be required, and in extremely severe cases, amputation of a limb.
