Cutaneous hyperpigmentation following bleomycin sclerotherapy for vascular malformations
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Updated: Oct 10, 2025

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Published on: May 23, 2025
Kyle P Davis1, Megan M Gaffey1,2,3, Anvesh R Kompelli1
1Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Abstract:
Systemic bleomycin therapy is associated with pulmonary fibrosis and cutaneous side effects. While it is believed that there is little to no systemic distribution of bleomycin when utilized to treat vascular malformations (VMs), we present a case series in which cutaneous, adhesive-related hyperpigmentation suggests that there is systemic egress of bleomycin following direct puncture sclerotherapy (DPS). This risk of hyperpigmentation after intralesional bleomycin should be discussed with patients, and steps to minimize the chances of it occurring should be implemented.
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