Two cases of dermatoses koebnerizing within fields of previous radiotherapy

• Published in: Clinical and experimental dermatology Vol. 39; no. 8; pp. 900 - 903
• Main Authors: Hellen, R., Kiely, C., Murad, A., Mulligan, N., Coffey, J., Lenane, P., Moloney, F. J.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.12.2014; Oxford University Press
• Subjects: Adult; Breast Neoplasms - radiotherapy; Female; Humans; Middle Aged; Radiation Injuries - complications; Skin Diseases, Vesiculobullous - etiology; Urticaria Pigmentosa - etiology
• ISSN: 0307-6938; 1365-2230
• DOI: 10.1111/ced.12421

Summary We describe two patients with newly diagnosed dermatoses localizing to the radiotherapy field following treatment for breast cancer. Patient 1 was a 53‐year‐old woman who developed bullous morphoea on her left breast two years after radiotherapy. Patient 2 was a 43‐year‐old woman who developed urticaria pigmentosa on her right breast eight months after radiotherapy and similar lesions gradually developed beyond the radiotherapy field. Both patients experienced a significant delay in diagnosis due to diagnostic confusion and concern over breast cancer recurrence. Irradiated skin demonstrates gradual and sustained alterations in fibrosis due to the production of long‐lived cytokines and chemokines. These changes can induce a koebnerizing response in conditions such as morphoea and urticaria pigmentosa. We explore the mechanisms behind radiotherapy‐induced skin changes, and highlight the potential for radiotherapy to exacerbate or unmask underlying dermatoses and systemic disease in the months and years following treatment.