Moist desquamation is a description of the clinical pattern seen as a consequence of

radiation exposure Radiation is a moving form of energy, classified into ionizing and non-ionizing type. Ionizing radiation is further categorized into electromagnetic radiation (without matter) and particulate radiation (with matter). Electromagnetic radiation con ...

where the

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...

thins and then begins to weep because of loss of integrity of the epithelial barrier and decreased

oncotic pressure Oncotic pressure, or colloid osmotic-pressure, is a form of osmotic pressure induced by the proteins, notably albumin, in a blood vessel's plasma (blood/liquid) that causes a pull on fluid back into the capillary. Participating colloids displace ...

. Typically this occurs at doses of 15–20

Gray Grey (more common in British English) or gray (more common in American English) is an intermediate color between black and white. It is a neutral or achromatic color, meaning literally that it is "without color", because it can be composed o ...

, far higher than any diagnostic scan and more typical of levels seen in radiotherapy or deployment of nuclear armament. Historically, this was a common phenomenon in

Hiroshima is the capital of Hiroshima Prefecture in Japan. , the city had an estimated population of 1,199,391. The gross domestic product (GDP) in Greater Hiroshima, Hiroshima Urban Employment Area, was US$61.3 billion as of 2010. Kazumi Matsui h ...

and

Nagasaki is the capital and the largest city of Nagasaki Prefecture on the island of Kyushu in Japan. It became the sole port used for trade with the Portuguese and Dutch during the 16th through 19th centuries. The Hidden Christian Sites in the ...

during

World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposin ...

with the

atomic bomb A nuclear weapon is an explosive device that derives its destructive force from nuclear reactions, either fission (fission bomb) or a combination of fission and fusion reactions (thermonuclear bomb), producing a nuclear explosion. Both bomb ...

attacks from the

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...

.Huda, W. Review of Radiologic Physics. 3rd edition. Lippincott, Williams & Wilkins, 2009. The phenomenon was famously described by

John Hersey John Richard Hersey (June 17, 1914 – March 24, 1993) was an American writer and journalist. He is considered one of the earliest practitioners of the so-called New Journalism, in which storytelling techniques of fiction are adapted to n ...

in his 1946 article, and later book, ''Hiroshima''.

Clinical characteristics

Sloughing of the epidermis and exposure of the dermal layer clinically characterize moist desquamation. Outside of medical therapy, when moist desquamation is seen in the setting of nuclear warfare, the condition is generally thought to be fatal.

Treatment

Management of these partial-thickness wounds has been influenced by the Winter principle of moist wound healing, which suggests that wounds heal more rapidly in a moist environment. Hydrocolloid dressings applied directly to these wounds prevent the evaporation of moisture from the exposed dermis and create a moist environment at the wound site that promotes cell migration.

References

{{reflist Radiation health effects