TOPICAL STEROIDS IN DERMATITIS
base contains a radio-sensitising agent. The possibility of
two populations reacting differently to irradiation is
discussed. However, Glicksman (1960) found no
evidence of correlation between intensity of skin
reaction and colour of skin comparing fair-skinned,
a v erage-complexioned and Negro patients. The
severity of radiation dermatitis is dependent on the
a mount of rads and the penetrative depth of the
radiation given, however, we have found no statistical
difference, possibly due to small numbers, in skin
reactions in patients treated on machines with
different energies, though a trend for severer
reactions to appear was seen in the clobetasone group
treated on the 250 kV machine, even though both
groups received similar applied doses. Hiiter and
Muller (1959) found no benefit in the prophylactic
daily use of hydrocortisone cream when applied to
the skin of some patients having pelvic irradiation
using 250 kV.
It is concluded that of the two creams, 1% hydro-
cortisone is superior to clobetasone butyrate in that
there were statistically fewer severe reactions in that
group. The authors are of the opinion that neither of
the two creams should be used ab initio and that
calamine and tannic lotion is probably the best
general agent for controlling skin reaction, though 1%
hydrocortisone cream has a place in the management
403
of more severe radiation reactions or small areas of
moist desquamation.
Acknowledgements. The authors with to thank their
consultant colleagues and radiographers at the Royal Marsden
Hospital for their agreement in participating in this trial and
their many helpful comments. Special thanks to Dr H. J. G.
Bloom for his help with the manuscript, and to all the
patients involved.
REFERENCES
I3jornberg, A., Hellgren, L. & Olsson, S. (1964). "Break
through phenomenon" during treatment of radiation
dermatitis with flucinolone acetonide. Acta Allergologica,
XIX, 515 —518.
Bjornberg, A., Hellgren, L., Magnusson, B., Mattsson, I. &
Rosengren, B. (1967). Topical treatment of radiation
dermatitis with hethamethasone-17-valerate, vaseline and
eucerine. A double-blind comparison. Clinical Radiology,
18,463- 464.
Glicksman, A. S_, Chu, F. C. H., Bane, H. N. & Nickson, J. J.
(1960). Quantitative and qualitative evaluation of skin
erythema. II Clinical study in patients on a standardised
irradiation schedule. Radiology, 75, 411 —415_
Hitter, K. A. & Muller, H. G. (1959). Stahlenreaktion der
haut bei Anwendung von glukokortikoiden. Strahlen-
therapie, 108, 457 -477.