title: Two cases of dermatoses koebnerizing within fields of previous radiotherapy.
abstract: 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.
authors.affiliation: Mater Misericordiae Hospital, Eccles Street, Dublin, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Hellen
authors.forename: C
authors.initials: C
authors.lastname: Kiely
authors.forename: A
authors.initials: A
authors.lastname: Murad
authors.forename: N
authors.initials: N
authors.lastname: Mulligan
authors.forename: J
authors.initials: J
authors.lastname: Coffey
authors.forename: P
authors.initials: P
authors.lastname: Lenane
authors.forename: F J
authors.initials: FJ
authors.lastname: Moloney
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011832:Radiation Injuries / Q000150:complications*; D012872:Skin Diseases, Vesiculobullous / Q000209:etiology*; D014582:Urticaria Pigmentosa / Q000209:etiology*