There are varied grades of severity of radiation dermatitis, each presented with different symptoms.

Grade 1 refers to a mild to moderate scale in terms of severity, which can be managed by the patient himself, without needing medical attention. The key features in this state include,

• Eryhtema, with pigmentation (ranging from pink to dusky in appearance) appearing like a sunburn in most cases. It is often ignored as it affects mostly the back, which is the most common body part exposed to these rays.
• Mild edema near the affected area, accompanied by discomfort and an itching sensation.
• Dry desquamation, accompanied by flaking and peeling skin (superficial layer).
• Partial loss of epidermal basal cells, with occasional hyperpigmentation.

Grade 2 and 3 refer to a slightly severe condition which requires medical attention within 24 hours of manifestations of symptoms, which include,

• Sloughing (shedding) of the epidermis and exposure of the dermal layer, with subsequent (severe) erythema.
• Drainage of serous fluids (pale, yellow, protein rich fluids secreted by the serous glands, beneath the epidermis) from the affected spot.
• Formation of blisters (bullous dermatitis) and vesicles.
• Severe pain and discomfort.

Grade 4 is a rare occurrence which needs immediate medical attention. It is typically characterized by,

• Skin necrosis and ulceration (typically when exposed to very high radiations, fractionated dosages ranging from 18 to 24Gy).
• Spontaneous bleeding from the affected areas.

 

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