Topical betamethasone for prevention of radiation dermatitis.

BACKGROUND: Although acute radiation dermatitis (ARD) is a common side-effect of radiotherapy (RT), currently there is no general consensus about its prevention or treatment of choice. AIMS: The purpose of this study was to investigate whether prophylactic use of topical betamethasone 0.1% can prevent ARD caused by chest wall irradiation. METHODS: Fifty-one patients who underwent modified radical mastectomy for breast cancer and were going to receive RT, were randomly assigned to receive topical betamethasone 0.1%, petrolatum or none during RT. The frequency and severity of ARD (measured using Radiation Therapy Oncology Group acute radiation morbidity scoring criteria) were recorded at the end of each week during RT and two weeks after its completion. Clinical outcomes were analyzed by relevant statistical methods. RESULTS: All patients developed some degree of ARD, the frequency and severity of which increased with time and reached the maximum at the end of the seventh week for all groups. Patients receiving betamethasone had less severe ARD than the other two groups throughout the course of the study, but this difference was significant only at the end of the third week (p = 0.027). No significant difference was observed between the petrolatum and control arms. CONCLUSION: Prophylactic and ongoing use of topical betamethasone 0.1% during chest wall RT for breast cancer delays occurrence of ARD but does not prevent it. Petrolatum has no effect on the prevention of ARD in these patients.

Long-term pruritus as the initial and sole clinical manifestation of occult Hodgkin's disease.

Pruritus or itch is a frequent symptom of patients with Hodgkin's disease. It often occurs during the clinical course of the disease and rarely may precede the diagnosis of underlying disease. In this report, we present a 16-year-old patient who had history of generalized pruritus without any skin rash for 4 years before the diagnosis of Hodgkin's disease. Within that period, she had received symptom-oriented medications, with no significant effect. After the first cycle of chemotherapy, her pruritus resolved completely. This case suggests that long-term generalized pruritus may be indicative of a significant underlying problem like Hodgkin's disease.

Primary epidural malignant hemangiopericytoma of thoracic spinal column causing cord compression: case report

CONTEXTO: Hemangiopericitoma é uma neoplasia mensequimal incomum que raramente afeta o canal espinhal. O hemangiopericitoma maligno primário da coluna vertebral é extremamente raro. RELATO DE CASO: Relatamos um caso de hemangiopericitoma maligno epidural primário da coluna vertebral torácica que invade o osso vertebral, causando a compressão do cordão espinhal em um homem de 21 anos. O paciente apresentou-se com dor progressiva nas costas durante quatro meses, que progrediu para paraparesia, parestesia bilateral do pé e incontinência urinária. A intervenção cirúrgica com laminectomia e ressecção do tumor e fixação posterior foi executada. A radioterapia pós-operatória no campo envolvido foi realizada. Marcante melhoria neurológica foi observada subseqüentemente. Descrevemos as características clínicas, radiológicas, e histológicas deste tumor e revemos a literatura.