Possible consequences of using X-ray devices as imaging support during surgical practices may be the development of skin diseases due to the combination of high local dose and long exposition time. Our group developed an original dosimeter which meets the following requirements: transparency to X-ray to avoid image degradation, measurement and localization in real-time of the dose absorbed by the skin on the whole exposed surface. The main purpose of this dosimeter is to allow the practitioner to change the beam orientation during the intervention in order to reduce the local dose and then avoid, in the extreme cases, the development of tumors. The dosimeter is composed of a lattice of scintillator fibers connected to a 64 channels photomultiplier tube. The detector combined with an appropriate electronics provides in real time an accurate measurement of the dose on the whole exposed surface. A linear relation between the photon count rate and the dose is demonstrated. Our dosimeter provides also in real time a map of the dose which leads to a very efficient monitoring of the dose during all the exposition time. (C) 2004 Elsevier B.V. All rights reserved.