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Daniel A. Lichtenstein, MD; Laurent Klapholz, MD; Daniel A. Vardy, MD; Israel Leichter, MD; Maurice Mosseri, MD; Sydney N. Klaus, MD; Leon T. Gilead, MD, PhD

Arch Dermatol. 1996;132(6):663-667.

Abstract
Background
Fluoroscopy and cineradiography used during coronary angiography expose patients to some of the highest doses of ionizing radiation in diagnostic radiology. The possibility of radiation-induced damage has been discussed by several authors in the past. However, to the best of our knowledge, chronic radiation dermatitis caused by exposure to x-rays during cardiac catheterization has not been described.

Observations
We describe 4 patients in whom chronic radiodermatitis developed following multiple cardiac catheterizations and coronary angioplasties. The cumulative radiation doses to which these patients were exposed were retrospectively calculated to be a mean of 24.6 Gy per patient, with a range of 11.4 to 34.9 Gy.

Conclusions
Chronic radiodermatitis is a threat in patients undergoing multiple cardiac catheterizations and angioplasties. In susceptible patients, radiation doses as small as 11.4 Gy, which can sometimes be emitted during 1 or 2 procedures, are potentially harmful. Awareness and protective measures against this long-term side effect of cardiac catheterization should be encouraged.

(Arch Dermatol. 1996;132:663-667)

Author Affiliations
From the Departments of Dermatology (Drs Lichtenstein, Klapholz, Vardy, Klaus, and Gilead), Radiology (Dr Leichter), and Cardiology (Dr Mosseri), Hadassah University Hospital, Jerusalem, Israel.

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