Radiation-induced inflammatory dermatosis: Another facet of the immunocompromised cutaneous district

To the Editor: We read with great interest the letter by De Vita et al1 published in this issue of the Journal that discusses the putative mechanisms underlying our case of radiation-induced hidradenitis suppurativa.2 The authors suggested this clinical presentation to be a typical example of "isoradiotopic response," where the onset of a new skin disease is strikingly limited to a skin area previously exposed to ionizing radiation,3 and of an "immunocompromised cutaneous district" (ICD) where the mechanisms involved in any secondary disorder occurring on irradiated skin areas are connected to local dysfunction of lymph drainage or neuroimmune signaling resulting in immune dysregulation.