Bleomycin-induced skin toxicity: is it always flagellate erythema?

Abstract

Bleomycin-induced skin toxicity is a rare and unique complication. We report a 35-year-old man with nodular lymphocytic predominant Hodgkin's lymphoma, stage IVB, who was started on adriamycin, bleomycin, vinblastin and dacarbazine (ABVD) chemotherapy. He developed pruritic hyperpigmented, patchy skin lesions on the neck, back, chest and thighs after IA cycle of ABVD chemotherapy. Lesions were not typical flagellate rash but hyperpigmented, patchy and mildly pruritic lesions over the trunk and proximal extremities. Lesions increased with continuation of bleomycin and improved gradually after removing the drug from chemotherapy schedule. The patient was in complete remission after VI cycles of chemotherapy (AVD Regimen) and skin lesions healed with minimal residual hyperpigmentation.

The development of flagellate hyperpigmentation after use of bleomycin for sclerotherapy slow flow vascular malformations

“…В первой части обзора был проведен анализ 12 статей, с описанием клинических наблюдений развития хлыстовой гиперпигментации после химиотерапии различных новообразований с системным введением блеомицина у 12 пациентов (табл. 1) [28][29][30][31][32][33][34][35][36][37][38][39]. В данной группе только 1 больной был детского возраста -мальчик 15 лет, получал химиотерапию по поводу внутричерепной опухоли.…”

Bleomycin induced hyperpigmentation of skin

“…1 Pulmonary complications are common but skin changes are rare and include hyper-pigmentation, plaques, hyperkeratotic lesions, erythema multiforme, alopecia, stomatitis and nail changes. 2 The exact mechanism of skin changes caused by bleomycin is not known. The treatment involves management of underlying disorders or withdrawal of the offending drug.…”