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Fighter aircraft and ejection: Report of a rare, unique occupational skin hazard

1 Department of Dermatology, Command Hospital Air Force, Bangalore, Karnataka, India
2 Department of Research Wing, Institute of Aerospace Medicine, Bangalore, Karnataka, India
3 Department ofPathology, Command Hospital Air Force, Bangalore, Karnataka, India

Date of Web Publication29-May-2019

Correspondence Address:
Sandeep Arora,
Department of Dermatology, Command Hospital Air Force, Bangalore - 560 007, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2229-5178.259288

How to cite this URL:
Arora S, Radhakrishnan S, Sharma V, Moorchung N. Fighter aircraft and ejection: Report of a rare, unique occupational skin hazard. Indian Dermatol Online J [Epub ahead of print] [cited 2019 Aug 21]. Available from: http://www.idoj.in/preprintarticle.asp?id=259288


Military aviation as compared to commercial aviation presents a complex environment to the pilot not only while flying but also in rare cases of ejections from fighter aircraft.[1] Aircraft ejection sequence is an extremely intricate process unique to fighters, which aims at preservation of pilot's life with possibly no injuries. Usually, it is the physical injuries apart from the sudden decompression at higher altitudes, which are the main concerns of this process. Cutaneous injuries by fragments and skin burns have been reported in the past.[2] We came across a case with traumatic tattooing[3] of canopy fragments suffered during ejection.

A pilot presented to us with a rash over his right shoulder and neck of 6 months' duration following an ejection from a fighter aircraft. He suffered no other skin injuries. There was no history of itching, pain, extrusion of grains or any other material from the affected area. Examination revealed a clinically quiescent skin, with skin colored to grey papules over the right shoulder extending onto the nape of the neck [Figure 1] with no evidence of inflammation, excoriations, discharge, or other secondary changes. Skin biopsy revealed unremarkable epidermis and adnexa with a refractile foreign body surrounded by mild inflammation with concentrically arranged lymphocytes and few interspersed foamy macrophages and foreign body giant cells [Figure 2]. The findings were consistent with a clinical impression of an abrasive traumatic tattoo[3] inflicted by canopy fragmentation while ejecting with histopathological evidence of a mild foreign body granulomatous reaction. The management of these cases involves either masterly inactivity in old standing cases, those with a large area of involvement, or physical removal of the impregnated foreign material with laser resurfacing or Q-switched Nd YAG laser.[4] Our case in view of his quiescent skin with mild histopathological changes was placed on follow-up with a plan of removal of the fragments in case he turned symptomatic.
Figure 1: Skin colored to grey papules over the nape of neck and shoulder

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Figure 2: Normal epidermis with a refractile dermal foreign body surrounded by mild inflammation with concentrically arranged lymphocytes and few interspersed foamy macrophages and foreign body giant cells H and E 10X (Left); Refractile body under polarizing filter H and E 10X with polarizing filter 400 nm

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A part of the ejection sequence of the pilot egress from the aircraft entails the aircraft canopy be either jettisoned or disintegrate by various means to allow safe pathway to the seated pilot. Canopy material must thus be carefully chosen to withstand pressure differences, and high impact forces, but also be lightweight, have ideal optical properties, disintegrate easily enough, and be made of inert material. Newer composite or sandwich materials made from polycarbonate are being increasingly used with impregnated miniature detonation cords or linear cutting charges for explosive disintegration of canopy [Figure 3]. Protection offered to the pilot is the helmet with the visor and mask for the head and face and the flying clothing for the rest. Canopy explosion may result in molten sheath material induced damage or lead splatter causing skin burns or eye injuries.[5] Through-canopy ejection in the past did result in perspex induced physical injuries, but these, with improved canopy materials are rare,[6] and it is widely believed that superficial injuries to ejecting pilots and their equipment is reportedly not a hazard with the canopy fragmentation systems.[7] This makes our observation unique, but still a possibility, which needs to be considered while studying the pathomechanics of fighter ejection. The inertness of the canopy material was responsible for a milder histopathological reaction in an otherwise clinically quiet skin.
Figure 3: Representational image showing canopy of the fighter aircraft with explosive miniature detonation cord built in

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The case is reported for its uniqueness, and to alert the dermatologists and aircraft manufacturers of this possible hazard of canopy fragment induced injury.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Arora S. Aerospace dermatology. Indian J Dermatol 2017;62:79-84.  Back to cited text no. 1
[PUBMED]  [Full text]  
Lewis ME. Survivability and injuries from use of rocket-assisted ejection seats: Analysis of 232 cases. Aviat SpaceEnviron Med 2006;77:936-43.  Back to cited text no. 2
Agris J. J Trauma 1976;16:798-802.  Back to cited text no. 3
Gorouhi F, Davari P, Kashani MN, Firooz A. Treatment of traumatic tattoo with the Q-switched Nd: YAG laser. J Cosmet Laser Ther 2007;9:253-5.  Back to cited text no. 4
Pipraiya R. Ejection in unusual aircraft attitude: A case report. Ind J Aerospace Med Ind 2013;57:45-8.  Back to cited text no. 5
Wright P, Scott RAH. Optics and Vision. In: Rainford DJ, Gradwell DP, editors. Ernsting's Aviation Medicine. 4th ed. London: Edward Arnold; 2006. p. 273-91.  Back to cited text no. 6
Chiou WY, Ho BL, Kellogg DL. Hazard potential of ejection with canopy fragmentation. Aviat Space Environ Med 1993;64:9-13.  Back to cited text no. 7


  [Figure 1], [Figure 2], [Figure 3]


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