Scleroderma in association with the use of bleomycin: a report of 3 cases

Although an association between exposure to bleomycin and the development of scleroderma has been suspected, few cases are reported. We describe the development of cutaneous scleroderma in 3 patients coincident with the use of bleomycin in low cumulative doses of less than 100 U. Dramatic clinical improvement occurred in 2 patients treated with high dose steroids. Our series of 3 patients supports a causal connection between bleomycin and scleroderma. In light of the widespread use of bleomycin, this complication may be under-appreciated.