Grading and nursing of radiation dermatitis in nasopharyngeal carcinoma

Grading and care of radiation dermatitis in nasopharyngeal carcinoma? Radiation dermatitis often occurs during or at the end of radiotherapy for nasopharyngeal carcinoma. It is manifested by erythema on the local skin of the irradiated field due to capillary dilation, followed by pigmentation; microthrombosis in small blood vessels leads to local hypoxia and secondary cell damage and death, peeling, hair loss, ulcers, bleeding, necrosis, or edema due to fluid retention. In severe cases, even long-lasting ulcers may occur.

According to the severity of radiation dermatitis caused by radiotherapy, it is clinically divided into 5 degrees, namely 0 degree, Ⅰ degree, Ⅱ degree, Ⅲ degree, and Ⅳ degree. The specific manifestations are as follows:

0 degrees: No symptoms or discomfort.

Grade I: Symptoms are mild and may manifest as dark red patches on the skin like follicles, a small amount of hair loss, dry peeling, or decreased sweating.

Grade II: Based on the previous degree, skin tenderness, bright erythema, flaky moist peeling, or moderate edema may occur.

Grade III: manifested as confluent moist desquamation or pitting edema in areas other than skin folds.

Grade IV: manifested by skin ulcers, bleeding and necrosis, accompanied by pain.

However, the acute radiation reaction caused by radiotherapy in most patients is usually mild and limited to a small range of symptoms, generally between degree 0 and degree II. It usually disappears or is relieved after a few weeks, and a blood scab will form 3 to 4 weeks after completing radiotherapy. For patients with degree III or above, it takes weeks to months to subside, but the skin affected by radiation may never return to normal.