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Differential Radiation Dermatitis in Native Skin and an Autologous Transplanted Myocutaneous Flap ONLINE FIRST

Viswanath R. Belum, MD1; Amanda Hill, RN2; Evan Matros, MD3; Mario E. Lacouture, MD1; Christopher A. Barker, MD2
[+] Author Affiliations
1Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
2Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York
3Plastic and Reconstructive Surgical Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
JAMA Dermatol. Published online August 06, 2014. doi:10.1001/jamadermatol.2014.888
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In this case, radiation dermatitis (RD) is characterized by a differential response in 2 developmentally equivalent tissues from distinct anatomic locations.

Article InformationCorresponding Author: Mario E. Lacouture, MD, Dermatology Service, Memorial Sloan-Kettering Cancer Center, Rockefeller Outpatient Pavilion, Ste 228, 160 E 53rd St, New York, NY 10022 (lacoutum@mskcc.org).

Published Online: August 6, 2014. doi:10.1001/jamadermatol.2014.888.

Conflict of Interest Disclosures: Dr Lacouture has served as a speaker, consultant, or advisor with Advancell, AstraZeneca, Aveo, Bayer, BergPharma, Bristol-Myers Squibb, Galderma, Genentech, Genzyme, GlaxoSmithKline, Helsinn, Imclone, Lilly, LindiSkin, Merck, Novocure, Novartis, Onyx, Pfizer, Roche, Sandoz, Sanofi Aventis and Wyeth. Dr Barker serves as a consultant to RP Pharmaceuticals.

Additional Contributions: We are indebted to Ying Zhou, MS, for assistance with in vivo dosimetry.

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Figure.
Clinical Images of Differential Radiation Dermatitis in Native Skin and an Autologous Transplanted Myocutaneous Flap

A, Prior to surgery, an infiltrative basal cell carcinoma of the upper chest had invaded the sternum, manubrium, left clavicle, and soft tissues of the anterior mediastinum and neck. B, Clinical image taken after autologous myocutaneous free flap reconstruction, following radical resection of the anterior chest wall and bilateral neck dissection. C, Grade 2, radiation dermatitis manifesting as brisk erythema with dry desquamation over the neck and upper chest; note the marked sparing of the skin within the flap (inset).

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