Pruritic Rash in a Patient with Hodgkin's Lymphoma

Bleomycin-induced flagellate erythema (FE), a skin finding associated with cutaneous deposition of bleomycin, is so called due to its characteristic pattern of whip-like, linear streaks. As bleomycin use in standard chemotherapeutic regimens has decreased, the clinical diagnosis has become increasingly rare. The authors present a case of a 43-year-old female patient with Hodgkin's lymphoma on her first cycle of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) treatment, who subsequently developed a diffuse rash classic for FE. This benign condition is important to recognize to avoid potentially unnecessary and harmful treatment for other dermatologic diagnoses for which it may be mistaken. In severe cases of FE, discontinuation of bleomycin should be considered.