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Flagellate pigmentation from intrapleural bleomycin. A light microscopy and electron microscopy study.
Journal of the American Academy of Dermatology
|September 1, 1985
Summary
A patient developed flagellate skin hyperpigmentation after a single dose of bleomycin for pleural mesothelioma. This is the first reported case linking this side effect to low-dose intrapleural bleomycin sclerotherapy.
Area of Science:
- Oncology
- Dermatology
- Pulmonology
Background:
- Pleural mesothelioma is a rare malignancy arising from the pleura.
- Bleomycin is a chemotherapy agent used in treating various cancers.
- Intrapleural bleomycin instillation is a palliative treatment for malignant pleural effusions.
Observation:
- A 65-year-old man with left pleural mesothelioma received a single intrapleural bleomycin instillation for cavitary sclerosis.
- One month post-treatment, the patient presented with characteristic pigmented flagellate streaks on his arms and chest wall.
Findings:
- This case is the first to document pigmented flagellate dermatopathy following a single, small dose of intrapleural bleomycin.
- The observed pigmentary changes are consistent with a hypersensitivity reaction or direct toxic effect of bleomycin.
Implications:
- This finding highlights a potential, previously unreported cutaneous side effect of intrapleural bleomycin sclerotherapy.
- Clinicians should be aware of this dermatological manifestation when using bleomycin for pleural conditions.
- Further investigation may be warranted to understand the mechanism and incidence of this bleomycin-induced skin reaction.