Cranial irradiation is commonly used in childhood leukemia, with many potential cutaneous adverse effects. Radiation-induced permanent alopecia owing to scalp fibrosis is a rare but disturbing side effect.
Objective and Conclusion:
Here we report a Saudi boy with acute T-cell lymphoblastic leukemia who developed radiation-induced cicatricial alopecia. Topical treatment using minoxidil solution was tried but was ineffective.
PuiCHEvansWE. Treatment of acute lymphoblastic leukemia. N Engl J Med2006;354:166–78.
3.
LawendaBDGagneHMGiergaDP. Permanent alopecia after cranial irradiation: Dose-response relationship. Int J Radiat Oncol Biol Phys2004;60:879–87.
4.
MetzJMSmithDMickR. A phase I study of topical Tempol for the prevention of alopecia induced by whole brain radiotherapy. Clin Cancer Res2004;10:6411–7.
5.
MalkinsonF. Radiobiology of the skin. In: FreedbergIEisenAWolffK, editors, Fitzpatrick's dermatology in general medicine. 5th ed.New York: McGraw-Hill; 1999. p. 1514–23.
6.
McWhirterWRMaselJP. Leukemia. In: McWhiterWMaselJ, editors. Pediatric oncology: an illustrated introduction. Sydney: Williams and Wilkins; 1987. p. 72–97.
7.
WaberDPShapiroBLCarpentieriSC. Excellent therapeutic efficacy and minimal late neurotoxicity in children treated with 18 grays of cranial radiation therapy for high-risk acute lymphoblastic leukemia: A 7-year follow-up study of the Dana-Farber Cancer Institute Consortium Protocol 87-01. Cancer2001;92:15–22.
8.
SchrappeMReiterALudwigWD. Improved outcome in childhood acute lymphoblastic leukemia despite reduced use of anthracyclines and cranial radiotherapy: Results of trial ALL-BFM 90. German-Austrian-Swiss ALL-BFM Study Group. Blood2000;95:3310–22.
9.
FajardoL. Morphology of radiation effects on normal tissues. In: PerezCBradyL, editors. Principles and practice of radiation oncology. 3rd ed.Philadelphia: Lippincott-Raven; 1998. p. 143–54.
10.
ValkPEDillonWP. Radiation injury of the brain. AJNR Am J Neuroradiol1991;12:45–62.
11.
DunbarSFTarbellNJKooyHM. Stereotactic radiotherapy for pediatric and adult brain tumors: Preliminary report. Int J Radiat Oncol Biol Phys1994;30:531–9.
12.
LoefflerJSSiddonRLWenPY. Stereotactic radiosurgery of the brain using a standard linear accelerator: A study of early and late effects. Radiother Oncol1990;17:311–21.
13.
SeversGAGriffinTWerner-WasikM. Cicatricial alopecia secondary to radiation therapy: Case report and review of the literature. Cutis2008;81:147–53.