Erythema Multiforme Following Deep X-Ray Therapy

LOCALIZED primary radiation dermatitis resulting from deep x-ray therapy is commonly known, as is the eczematoid dermatitis that sometimes occurs in and about the irradiated site. However, a generalized cutaneous reaction due to radiotherapy, appearing distant to the portal of irradiation, is not well known. Consequently there is a dearth of information on this subject. In 1903, Holzknecht, the famous Viennese radiologist, reported generalized cutaneous reactions following single large doses of superficial x-rays sufficient to produce moderately severe localized x-ray dermatitis. Since then, sporadic reports have appeared in the dermatological and radiological literature by Epstein,1Schreiner,2Kautzky,3Pardo-Castello,4Bray,5Moore,6Maccagno,7Castigliano,8Hopkins,9and, more recently, Arnold.10 The reaction which may follow deep x-ray therapy consists of a definite symptom complex with characteristic clinical and laboratory features. A generalized rash may appear within 2 to 21 days after