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Indications for radiotherapy: benign skin disease


Some of the misconceptions about the role of radiotherapy have arisen because of its widespread use in the past for the treatment of benign conditions. X-ray production was discovered in 1895, and soon afterwards it was noted that the antiproliferative effect of low energy X-rays was advantageous in the short term in a variety of visible tumours and benign dermatoses, and sometimes multiple retreatments were offered. There was, however, no dose measurement apart from the biological effect of ‘skin erythema’, no radiation protection for workers or patients, and no appreciation of the late effects of radiodermatitis, leukaemia and other malignancies, and of skin cancer induction after a very long latent period. Radiation epilation for tinea capitis, a treatment offered widely in Europe, well demonstrates radiation carcinogenesis. In a series of 2200 who received X-ray epilation treatment for scalp ringworm during the 1940s and 50s, and who were subsequently followed by mail questionnaire for an average of 26 years, 41 had one or more BCCs of scalp or face (80 lesions in 41 cases), whereas there were only three BCCs in a comparable group of 1400 treated without X-ray [1] . Skin cancers induced by this treatment have a very long latent period, often over 30 years, and cases treated in the 1930s and 40s have been seen until recently in cancer treatment centres in the UK ( Fig. 79.5 ... log in or subscribe to read full text

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