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[Flagellate dermatitis after bleomycin chemotherapy in a patient with malignant germ cell tumor]
C Schummer1, Y Winkler2, J Tittelbach1
1Klinik für Hautkrankheiten, Universitätsklinikum Jena.
History And Clinical Findings:
A 49-year-old patient with malignant germ cell tumor within the first cycle PEB (platinum [P], etoposid [E] and bleomycin [B]) presented with an itchy linear papular erythema with discrete vesicles. The rash had appeared three days ago i. e. four days after the second application of bleomycin.
Investigations:
Visual diagnosis of a flagellate dermatitis.
Treatment And Clinical Course:
Primary treatment consisted of systemic antihistamines, local and systemic application of steroids. Bleomycin treatment was stopped and substituted by ifosfamide.
Conclusion:
Flagellate dermatitis occurs with an incidence up to 66 % after bleomycin treatment. There is no association between bleomycin dose and incidence or severity of the lesions. Flagellate dermatitis is a self-limiting condition but hyperpigmentation may persist. Similar lesions may occur with bendamustine and docetaxel, the intake of insufficiently cooked shiitake mushrooms as well as in dermatomyositis and Still's syndrome.
