A reminder of bleomycin-induced hyperpigmentation

• Bleomycin is a  chemotherapeutical cancer treatment generally for soft cell neoplasia
• Incidence of bleomycin-induced hyperpigmentation would reach 20% of all patients taking bleomycin
• The authors describe the case of a 23 year old woman who had ovarian dysgerminome. Treatment of bleomycin was given at a dosage of 30mg every week. 4 weeks after beginning the treatment, she developed flagellate hyperpigmentation (itchy, located on trunks and extremities )

About flagellate hyperpigmentation

• It occurs anywhere from 24 hours to 9 weeks after first administration
• The cumulative dose of bleomycin reaches 100 to 300mg
• Etiological hypotheses:
  • scratching the skin and irritation from clothing (due to drug toxicity)
  • intracellular accumulation of melanin
• It usually fades in 4 months after the drug is stopped

Source of information. Cayirli M. et al. Bleomycin induced flagellate hyperpigmentation – a case report. p1411. European Academy of Dermatology and Venereology (EADV) Annual Meeting – Istanbul, Turkey, 2-6 October 2013