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Fig 1.

Digital photographs of the measurement areas 1 (irradiated skin) and 2 (reference area on contralateral breast) under standardized lighting and with calibration of the images using a color reference card.

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Table 1.

Patient characteristics and univariate comparison between treatment groups.

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Fig 2.

Grading of acute skin toxicity according to CTCAE 4.03 by two radiation oncologists independently of each other exhibited significant inter-observer variability (p<0.001).

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Fig 3.

Color measurements showed significant differences of the mean L*a*b* values (p<0.001) between irradiated skin (measurement area 1) and not irradiated control (measurement area 2).

Error bars show ± 1 standard deviation (SD).

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Fig 3 Expand

Fig 4.

Skin treated with Bepanthen exhibited less redness than the skin treated with R1&R2 (a* = 11.4 ± 4.0 (SD) vs. 15.6 ± 4.9 (SD), p<0.001), but a drop in the yellow component (b* = 13.4 ±3.9 vs. 17.0 ± 4.5, p<0.001).

There was no difference in L* values between the treatments. Error bars show ± 1 standard deviation (SD).

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Fig 5.

Comparison of CTCAE grade (according to radiation oncologist 1) and the mean SEV values.

Error bars show ± 1 standard deviation (SD). Mean difference between CTCAE grade 1 vs. 2 is SEV 205.6 (95%CI: 95.8–315.4; p<0.001), 1 vs. 3 is SEV 306.4 (95%CI: 76.4–536.4; p = 0.005) and 2 vs. 3 is 100.8 (95%CI: -124.7–326.3; p = 0.837).

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Fig 6.

The new parameter ΔSEV showed less change in skin color with Bepanthen than with R1&R2 (p<0.001).

Error bars show ± 1 standard deviation (SD).

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Fig 6 Expand