Figure 1. Manifestation stage of the cutaneous radiation syndrome (CRS). (A) Schematic drawing of the pathophysiological processes involved. (B) Clinical aspect of a manifestation stage, 24 h after accidental exposure of the lateral thorax to a cutaneous dose of 60 Gy of photons. An eroded blister and sterile pustules can be seen (iatrogenic accident in Germany, 1994). (C) High frequency ultrasound of manifestation stage on the upper arm, showing decreased dermal echogenicity as a sign of inflammatory interstitial oedema (Georgian accident, 1997). (D) Thermographic images of the back of a victim with an inflammatory reaction (Courtesy of Prof. J M Cosset, Institut Curie, Paris) (Georgian accident, 1997). (E) Ulcerative manifestation stage, suprapatellar region (Georgian accident, 1997).