Crux medicorum ulcerated radiation-induced fibrosis - successful therapy with pentoxifylline and vitamin E.

Case report of a 60 year-old patient with an ulcerated radiation-induced fibrosis after therapy for breast cancer. Treatment with oral administration of pentoxifylline 3 x 400 mg/day and vitamin E 2 x 200 mg/day was started. The ulcers were almost completely healed after 18 months. Sonographic examination showed a reduction in dermal thickness and in the laser Doppler fluxmetry, a regulation in the amplitude and increase in flux was found compared to the measurements made before the start of treatment. The therapy was very well tolerated without any side effects. The treatment of radiation-induced fibrosis with PTX and vitamin E is a practicable and cost-effective regimen, especially for inoperable patients. The efficacy of this treatment is probably due to a combination of blood flow stimulation and immune modulation which lead to a reduction in the fibrosis.