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,1 Schreiner,2 Kautzky,3 Pardo-Castello,4 Bray,5 Moore,6 Maccagno,7 Castigliano,8 Hopkins,9 and, 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
DAVIS J, PACK GT. ERYTHEMA MULTIFORME FOLLOWING DEEP X-RAY THERAPY. AMA Arch Derm Syphilol. 1952;66(1):41–48. doi:10.1001/archderm.1952.01530260044003