Bleomycin in dermatology: a review of intralesional applications

Intralesional bleomycin has been favorably used off-label to treat various skin conditions. These include warts, hemangiomas, vascular malformations, telangiectasias, several types of cutaneous malignancies, condyloma acuminata, and the lesions of leishmaniasis cutis. Currently, there is a limited amount of evidence from randomized placebo-controlled trials comparing intralesional bleomycin with other local treatments for these disorders. In this article, we review the pharmacodynamics, mechanism of action, safety profile, and clinical applications of intralesional bleomycin. Dosages, techniques for administration, and efficacy of intralesional bleomycin for each aforementioned clinical entity are also provided. Given its ease and safety in administration, efficacy, and availability, off-label use of intralesional bleomycin can be considered another primary and/or adjunctive therapy for various common cutaneous conditions by practitioners in dermatology today.