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A Discussion on the Skin Erythema Dose with Röntgen Rays: Some Biological Implications

1952; Wiley; Volume: 25; Issue: 294 Linguagem: Inglês

10.1259/0007-1285-25-294-326

1748-880X

John C. Belisario,

Cutaneous Melanoma Detection and Management

The term "skin erythema dose" when employed without further qualification in connection with X-ray effects on the skin is loose and inaccurate and tends to be extremely misleading. Nevertheless, the erythema reaction in the skin is the only practicable method of biological measurement in X-ray therapy which we possess at present, and while in no sense an accurate measure of a given amount of X rays, it is a useful method of judging or estimating the effects of the rays on human tissues, effects which are necessarily determined by the degree of damage caused to overlying skin. Literally the term "skin erythema dose" means a variable degree of redness or pink reaction of the skin which may be produced by amounts of X rays varying from approximately 200 r upwards, and has no significance apart from this. Yet it is used diversely by different workers to refer to minimal, threshold, maximum tolerated and all manner of erythema standards. For example, the skin erythema dose has been defined from the minimal amount of X rays that will produce a skin erythema, up to an amount that will produce an erosion; and these extremes cover variations of 700 per cent. (Harris, Leddy, and Sheard, 1932). Miescher (1923) described erythema of the skin as occurring in four waves. The first wave appeared on the 1st or 2nd day and usually disappeared by the 4th day; the second wave occurred from the 8th to the 22nd day, and the third wave from the 34th to the 157th day (the latter period might also include a fourth wave).