Ann Dermatol.  2019 Apr;31(2):251-253. 10.5021/ad.2019.31.2.251.

Squamous Cell Carcinoma on the Fingers of Orthopedic Surgeon Induced by Occupational Radiation Exposure

• Yoon HS
• Heo JH
• Lee SH
• Shin J
• Choi GS
• Byun JW

• KMID: 2439083
• DOI: http://doi.org/10.5021/ad.2019.31.2.251

Abstract

No abstract available.

MeSH Terms

Carcinoma, Squamous Cell*
Epithelial Cells*
Fingers*
Orthopedics*
Radiation Exposure*

Figure

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  Fig. 1 Painful crusted necrotic plaques and scale widely distributed in the right thumb, index, and 3rd finger, and left thumb and index finger. Each figure is as follows: (A) Both hands (B) right thumb (C) right index and 3rd finger (D) left thumb (E) left index finger. And photographs after 17 months of follow-up. Each figure is as follows: (F) Dorsal side of the left hand. There were three SCC lesions on the left index finger (arrows). (G) Ventral side of the right hand. There was a SCC lesion on the right third finger (arrow). (H) Right hand MRI image. On the T2 weighted image, SCC invasion is suspected in the medial cortex of the mid phalange and the marrow of the distal phalange of the right index finger. SCC: squamous cell carcinoma, MRI: magnetic resonance imaging.

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  Fig. 2 (A, B) Histopathologic findings of the nail bed of the right thumb (H&E: A, ×40; B, ×200). The skin biopsy showed atypical squamous cells invading into dermis forming sheet and individual keratinization.

Reference

1. Shim DM, Kim YM, Oh SK, Lim CM, Kown BT. Radiation induced hand necrosis of an orthopaedic surgeon who had treated a patient with fluoroscopy-guided spine injection. J Korean Orthop Assoc. 2014; 49:250–254.

2. ICRP. Radiological protection in fluoroscopically guided procedures outside the imaging department. ICRP Publication 117. Ann ICRP. 2010; 40.

3. Mehlman CT, DiPasquale TG. Radiation exposure to the orthopaedic surgical team during fluoroscopy: “how far away is far enough?”. J Orthop Trauma. 1997; 11:392–398.

4. Hegedus F, Mathew LM, Schwartz RA. Radiation dermatitis: an overview. Int J Dermatol. 2017; 56:909–914.

5. Dika E, Fanti PA, Patrizi A, Misciali C, Vaccari S, Piraccini BM. Mohs surgery for squamous cell carcinoma of the nail unit: 10 years of experience. Dermatol Surg. 2015; 41:1015–1019.