Moist desquamation

Moist desquamation is a description of the clinical pattern seen in radiotherapy where the skin thins and then starts to weep because of loss of integrity of the epithelial barrier.

Sloughing of the epidermis and exposure of the dermal layer clinically characterize moist desquamation. 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.[29] 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.

In a randomized prospective trial, hydrocolloid dressings were compared with gentian violet, a compound with antifungal and antiseptic properties used in some institutions to treat moist desquamation. Unlike the hydrocolloid dressings, gentian violet produces a dry wound bed. Thirty-nine patients who developed a total of 60 wounds during radiotherapy were randomized to treatment with either a hydrocolloid dressing or gentian violet. There were no significant differences in wound healing time. However, patients reported higher satisfaction with the hydrocolloid dressing based on its comfort and aesthetic factors. Gentian violet produced skin discoloration and drying affects that limited mobility.[30] Patient comfort should determine the best clinical practice, and at our institution hydrocolloid dressings are commonly prescribed for moist