This standard specifies the diagnostic criteria and treatment principles for acute and chronic skin damage caused by ionizing radiation. GB 8282-2000 Diagnostic criteria and treatment principles for radiation-induced skin diseases GB8282-2000 Standard download decompression password: www.bzxz.net

National Standard of the People's Republic of China
Dlagnostic criteria and principles ofmanagement for radlation skin diseasesUDC 616-07/ -08
: 616 -001.26
GB8282—87
This standard applies to radiation workers with skin diseases caused by ionizing radiation exposure. Non-occupational exposed personnel can also refer to this standard for diagnosis and treatment.
1 Acute radiation skin damage
Acute radiation skin damage includes acute radiation dermatitis and radiation skin and mucosal ulcers. 1.1 Diagnostic criteria
1.1.1 Acute radiation skin damage is skin damage caused by a single or multiple high-dose irradiation of a part of the body within a short period of time (several days). The reference value is 5Gy (with personal dose records). Comprehensive analysis and diagnosis of radiation workers should be conducted in combination with health records. 1.1.2 The main clinical manifestations and prognosis of skin irradiation vary according to the irradiation dose, radiation energy, irradiated site and physical condition. The diagnosis can be made according to the classification in Table 1:
Table 1 Diagnostic criteria for the classification of acute radiation skin injury Initial reaction
.1.2 Treatment principles
Erythema, numbness
Erythema, numbness,
Itching, edema
False healing period
1 to 3 weeks
Several hours to 10 days
1.2.1 When radionuclides are contaminated on the skin, they should be washed and decontaminated in time. Extreme
erythema, hair loss
Secondary erythema, hair
cystic rash, blisters
ulcers, necrosis
1.2.2 Grade I: No special treatment is required, and various stimulations to the irradiated area (including repeated irradiation) should be avoided. Reference agent salt
1.2.3 Grade II: Select drugs with low irritation, anti-infection ability, blood circulation improvement, and tissue growth promotion to keep the blister surface clean and sterile to prevent infection. When the blister tension is too large, the blister fluid can be drawn out with a sterile empty needle. 1.2.4 Grade III: Avoid infection of the ulcer surface, timely skin grafting, and protect local function. 2 Chronic radiation skin damage
Chronic radiation skin damage includes chronic radiation dermatitis, chronic radiation skin and mucosal ulcers, etc. Approved by the Ministry of Health of the People's Republic of China on December 10, 1987 and implemented on July 1, 1988
2.1 Diagnostic Standards
GB 8282-87bZxz.net
2.1.1 The local skin is exposed to radiation exceeding the dose equivalent limit for a long time, and the annual cumulative dose equivalent is generally greater than 15Sv (with personal dose records). Chronic changes in the skin and its appendages after several years of exposure can also be caused by acute radiation skin damage. Comprehensive analysis and diagnosis should be conducted in combination with health records.
2.1.2 Chronic radiation skin injury can be graded according to Table (2): Table 2 Diagnostic criteria for the grade of chronic radiation skin injury Grade
Clinical manifestations
Dry, flaky skin, loss of elasticity, desquamation, irregular or disordered fingerprints, dark or longitudinal nails, banded color, easy splitting of nail wax, hyperkeratosis, cracks, many wart-like protrusions or skin atrophy and thinning, disappearance of fingerprints, thickening and deformation of nails
Long-term unhealed ulcers, keratinous protrusions, severe keratinization of fingertips and fusion with nails, tendon contraction, joint stiffness 2.1.3 Viral infection, flat warts, contact dermatitis and other diseases should be ruled out. 2.2 Treatment principles
2.2.1 Symptomatic treatment should be used. For long-term unhealed ulcers or tissue hyperplasia, surgical treatment should be performed as much as possible. 2.2.2 For grade II and above chronic radiation skin damage, in addition to active treatment, radiation exposure should be reduced or avoided. 3 Radiation skin cancer
Radiation skin cancer refers to skin cancer that is clearly induced by ionizing radiation. 3.1 Diagnostic criteria
3.1.1 Radiation skin cancer must occur in areas of the skin that have been severely damaged by radiation. 3,1,2 Radiation skin cancer refers to malignant changes on the basis of hyperkeratosis or long-term radiation ulcers caused by radiation. Most of the cell types are squamous epithelial cells.
3.1.3 Any skin cancer such as basal cell carcinoma and melanoma that is not in areas of the skin that have been severely damaged by radiation cannot be diagnosed as radiation skin cancer.
3.2 Principles
3.2.1 The affected area should be kept away from radiation.
3.2.2 The blood vessels around radiation-induced skin cancer are mostly blocked by thickening of the intima, and cancer cells rarely metastasize to distant places. Therefore, the patient's limb function should be fully considered when performing tumor resection or finger amputation. GB8282-87
Appendix A
Instructions for the correct use of this standard
(reference)
A large number of clinical practices and research on radiation-induced skin injuries have provided a basis for us to revise a relatively complete diagnostic standard for radiation-induced skin injuries. This revision provides the diagnostic criteria and treatment principles for acute and chronic radiation skin damage and radiation skin cancer, and also provides a relatively clear grading standard for the former. In practice, the radiation dose values ​​that cause skin damage have been given relatively clearly, but due to the different radiation energies and different exposure conditions, it is still difficult to give an accurate universal dose. The radiation dose values ​​that cause certain skin injuries given in this standard are only reference values, and their clinical grading is still based mainly on clinical manifestations. The diagnosis of radiation damage is mainly based on the exposure history of local overdose equivalent limits, the exposure dose and the gradually revealed skin manifestations, and excludes skin diseases caused by chemical, infectious and other factors. It is generally believed that genetic and carcinogenic effects are random effects of ionizing radiation. However, radiation skin cancer occurs in areas of the skin that are severely damaged by radiation. At the same time, it is a malignant transformation on the basis of excessive keratinization caused by radiation or long-term unhealed radiation ulcers. This should be distinguished from basal cell carcinoma and melanoma that occur in areas that are not damaged by radiation. Skin cancers such as skin tumors and skin cancers are different. Simple radiation skin damage without systemic changes that can be diagnosed as radiation sickness cannot be diagnosed as radiation sickness. For those who have serious sequelae or even disability caused by occupational or work-related radiation, which affect their ability to take care of themselves, their treatment and treatment should refer to relevant national regulations, and the same applies to patients with occupational radiation skin tumors. The diagnosis and treatment of radiation skin damage is a highly technical cross-disciplinary task. Therefore, this standard should be carefully implemented by radiation medicine professional institutions and (or) radiation disease diagnosis teams at all levels. Additional notes:
This standard was proposed by the National Health Standards Technical Committee and reviewed and approved by the Radiation Disease Diagnosis Standard Subcommittee. This standard was drafted by the Shanghai Institute of Radiological Medicine. This standard is interpreted by the Ministry of Health's Industrial Hygiene Laboratory, the technical coordination unit entrusted by the Ministry of Health. From the date of implementation of this standard, the section on radiation skin damage in the original "Radiation Sickness Diagnosis Standards and Treatment Principles" (GBW1-80) will be invalidated.
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