Strahlungs-induzierter subakut kutaner Lupus erythematodes oder außergewöhnliche Radiodermatitis?

Zusammenfassung

Röntgenstrahlen, Gamma-Strahlen, UV- und sichtbares Licht sind Teil der elektromagnetischen Strahlung, aber mit unterschiedlicher Energie. UV-Licht stellt u. a. für den Lupus erythematodes einen bekannten Triggerfaktor dar, dagegen wird Röntgen- oder γ-Strahlung nur sehr selten als Triggerfaktor zur Auslösung spezifischer Dermatosen beschrieben. Am Beispiel einer Patientin mit bereits langjährig bekanntem subakut kutanem Lupus erythematodes (SCLE), die unter einer Radiatio aufgrund eines kleinzelligen Bronchialkarzinoms im Bestrahlungsareal des Kopfes eine ungewöhnliche Dermatitis entwickelte, sollen die verschiedenen Auslösefaktoren diskutiert werden. Möglich erscheint uns eine Exazerbation des bekannten SCLE im Sinne eines Köbnerphänomens durch elektromagnetische Bestrahlung jenseits ultravioletten Lichtes.

Abstract

X-rays, gamma-radiation, UV and visible light are part of the electromagnetic radiation but in ascending energy dosage. UV light is a well known trigger factor e. g. for lupus erythematosus. In contrast x-rays and γ-radiation have only rarely been described or studied as provocating specific dermatoses. A patient with long-standing SCLE and metastasizing lung cancer is reported with atypical skin lesions at the area of cranial radiotherapy that may be interpreted in different ways. One possible explanation in our case might be exacerbation of SCLE because of the Koebner phenomenon induced by electromagnetic radiation apart from ultraviolet light.

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