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Updated: May 2, 2026
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Published on: May 9, 2025
Flagellate erythema induced by bleomycin toxicity
L Appaji1, C Vasu Reddy2, B S Aruna Kumari1
1Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
Bleomycin, an anticancer drug, can cause a distinctive skin reaction called flagellate erythema. This self-limiting condition, observed in a patient with an intracranial germ cell tumor, may lead to lasting skin discoloration.
Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- Bleomycin is a chemotherapy agent used for various cancers.
- Its known toxicities include lung and skin damage, with relative bone marrow sparing.
- Cutaneous reactions are a recognized side effect of bleomycin treatment.
Purpose of the Study:
- To describe a specific skin reaction to bleomycin.
- To highlight flagellate erythema in the context of an intracranial germ cell tumor.
Main Methods:
- Case report presentation.
- Clinical observation of skin reaction.
- Review of bleomycin toxicity profiles.
Main Results:
- A patient with an intracranial germ cell tumor developed flagellate erythema.
- Flagellate erythema is a characteristic, self-limiting toxic reaction to bleomycin.
- This reaction can result in persistent hyperpigmentation.
Conclusions:
- Flagellate erythema is an important dermatological manifestation of bleomycin therapy.
- Awareness of this reaction is crucial for managing patients on bleomycin, particularly those with intracranial germ cell tumors.
- While self-limiting, the potential for residual hyperpigmentation should be considered.
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