radiation dermatitis [L, radiare, to emit rays; Gk, derma, skin, itis, inflammation] , an acute or chronic inflammation of the skin caused by exposure to ionizing radiation, as in cancer radiation therapy. There are four levels of involvement, which are graded from 1-4. Also called radiodermatitis. ▪ OBSERVATIONS: Symptoms may not appear until 3 weeks after exposure. Grade 1 includes mild erythema; grade 2, moderate to brisk erythema with patchy, moist desquamation. Grade 3 includes moist desquamation and bleeding induced by minor trauma or abrasions. Grade 4 is characterized by skin necrosis and ulceration. In severe cases the condition can progress to scarring, fibrosis, and atrophy. There may also be changes in skin pigmentation. ▪ INTERVENTIONS: Skin reactions should be assessed at least once a week. Washing and drying of the skin is recommended for all patients receiving radiotherapy. Topical applications can be considered on an individual basis and are prescribed for individuals with grade 2 and 3 dermatitis. This level of involvement mandates that care should be managed by a team that includes a radiation oncologist, a medical oncologist, a nurse, and a dermatologist. A wound specialist should be involved for grade 4 dermatitis. ▪ PATIENT CARE CONSIDERATIONS: Patients should be advised to avoid sun exposure, the use of irritants such as perfume and alcohol-based products, and to avoid scratching the area.
