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Underwater Endoscopic Injection Sclerotherapy for Gastroesophageal Varices

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Hyperpigmentation after Foamed Bleomycin Sclerotherapy for Vascular Malformations.

Heather C Milbar¹, Hana Jeon¹, Margaret A Ward¹

¹Department of Dermatology, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287.

Journal of Vascular and Interventional Radiology : JVIR

|April 9, 2019

Summary

Bleomycin sclerotherapy for vascular malformations can cause skin hyperpigmentation. These lesions, linked to pressure from medical devices, gradually fade over time.

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Area of Science:

Dermatology
Vascular Surgery

Background:

Sclerotherapy using bleomycin is a treatment for vascular malformations.
Bleomycin is an antineoplastic agent used off-label for sclerotherapy.

Observation:

Six patients developed hyperpigmented skin lesions post-bleomycin sclerotherapy.
Lesions appeared on the face, neck, and extremities.
Patients ranged from 2 to 65 years, encompassing diverse demographics.

Findings:

Hyperpigmentation was associated with postprocedural cutaneous pressure (e.g., ECG leads, tape).
Five of six patients received foamed bleomycin.
Lesions showed slow fading, persisting up to three years.

Implications:

Clinicians should be aware of potential hyperpigmentation after bleomycin sclerotherapy.
Minimizing cutaneous pressure during post-procedure care may reduce lesion incidence.
Understanding this side effect aids patient counseling and management of vascular malformations.