Moist desquamation
Moist desquamation is a description of the clinical pattern seen as a consequence of radiation exposure where the skin thins and then begins to weep because of loss of integrity of the epithelial barrier and decreased oncotic pressure. Moist desquamation is a rare complication for most forms of radiology, however it is far more common in fluoroscopy where threshold doses lie between 10-15 Gy and increasingly common above 15 Gy. It has been noted that fractionation of fluoroscopic procedures significantly reduces the likelihood of moist desquamation occurring. In animal studies done on pig skin, moist desquamation was found to occur with a 50% of the time after a single dose of 28 Gy, however a 2×18 Gy fractionation scheme (36 Gy total dose) was needed to produce the same 50% occurrence. Moist desquamation is a common side effect of radiotherapy treatment, where approximately 36% of radiotherpay patients will present with symptoms of moist desquamation. While modern Megavoltage external beam radiotherapy have peak radiation doses below the skin, older orthvoltage systems have peak radiation doses at the skin of a patient. As such, moist desquamtation and other skin related radiotherapy complications were significantly more commonplace before the introduction of higher energy