Intradermal Bleomycin Injections Into Normal Human Skin

Flagellate Hyperpigmentation Following Intralesional Bleomycin Treatment of Verruca Plantaris

“…At higher concentrations, bleomycin is cytostatic by blocking DNA uptake of thymidine in the S-phase of the cell cycle. [1][2][3][4] Intralesional bleomycin has been reported in multiple studies as being highly effective in the treatment of recalcitrant verruca vulgaris.…”

“…1,5 It is thought that the drug's efficacy in the treatment of verrucae is due to its effects on cellular DNA, which impede viral survivability by limiting turnover of host cells, but induction of tumor necrosis factor has also been reported as a possible mechanism. 4 It has been shown that expression and up-regulation of activation antigens (human leukocyte antigen class II) and cell adhesion molecules (intercellular adhesion molecule-1, endothelial leukocyte adhesion molecule-1, and vascular cell adhesion molecule-1) occur after the injection of bleomycin into human skin. 4 Given its toxic nature as a chemotherapeutic agent and the increased incidence of adverse effects, treatment of common warts with bleomycin has been limited to cases that do not respond to conventional therapies.…”

“…4 It has been shown that expression and up-regulation of activation antigens (human leukocyte antigen class II) and cell adhesion molecules (intercellular adhesion molecule-1, endothelial leukocyte adhesion molecule-1, and vascular cell adhesion molecule-1) occur after the injection of bleomycin into human skin. 4 Given its toxic nature as a chemotherapeutic agent and the increased incidence of adverse effects, treatment of common warts with bleomycin has been limited to cases that do not respond to conventional therapies. Some authors have raised the possibility of using bleomycin as a first-line agent because of the relatively simple procedure and increased patient satisfaction when compared with destructive modalities such as cryotherapy or electrocautery.…”

“…Incremental histopathologic responses, however, are shown at concentrations of up to 1 U/mL. 4 The optimal dosage for treatment of verrucae with bleomycin has not been established, but safe and effective ranges between 0.1 U and 2.0 U per treatment have been identified. 1,4 Cutaneous reactions to bleomycin are well documented.…”

“…4 The optimal dosage for treatment of verrucae with bleomycin has not been established, but safe and effective ranges between 0.1 U and 2.0 U per treatment have been identified. 1,4 Cutaneous reactions to bleomycin are well documented. Alopecia, stomatitis, and hyperpigmentation are commonly seen after systemic chemotherapy using bleomycin.…”