Bleomycin-Induced Flagellate Dermatitis

A Danish case of bleomycin‐induced flagellate erythema

“…The skin manifestations are often self-limiting. 4 Bleomycin is inactivated by the enzyme bleomycin hydrolase that is widely distributed in normal tissues except for the lungs and skin, which makes these sites | 2883 SOERENSEN aNd ULdaLL PaLLESEN target of toxicity. BIFE is a cutaneous side effect to treatment with bleomycin among several others, including Raynaud's phenomenon, gangrene, fibrosis, alopecia, edema, nail changes, and neutrophilic eccrine hidradenitis (NEH).…”

“…It is seen in 8%‐20% of the treated patients and is reported to develop from 2 hours to several weeks after the initial bleomycin treatment. The skin manifestations are often self‐limiting 4 . Bleomycin is inactivated by the enzyme bleomycin hydrolase that is widely distributed in normal tissues except for the lungs and skin, which makes these sites target of toxicity.…”

“…BIFE is a cutaneous side effect to treatment with bleomycin among several others, including Raynaud's phenomenon, gangrene, fibrosis, alopecia, edema, nail changes, and neutrophilic eccrine hidradenitis (NEH) 5 . The development of the condition appears to be independent of the dose and mode of administration, 4 and severe cases may require discontinuation of bleomycin, since no specific treatment has been identified 1,6 . However, as shown in the present case, it may be possible to continue the treatment with bleomycin with supportive therapy of antihistamines, topical, and oral corticosteroids 7‐9 .…”

The diverse methods of bleomycin delivery in cutaneous warts: A literature review

“…Common side effects include pain, eschar formation, pigmentation and onychodystrophy. Gangrene, flagellate dermatitis, scleroderma and Raynaud's phenomenon are rare adverse effects 8,15 . It is contraindicated in pregnancy, lactation, patients with Raynaud's phenomenon, peripheral vascular disease, and hypersensitivity to bleomycin 8 …”

“…Gangrene, flagellate dermatitis, scleroderma and Raynaud's phenomenon are rare adverse effects. 8,15 It is contraindicated in pregnancy, lactation, patients with Raynaud's phenomenon, peripheral vascular disease, and hypersensitivity to bleomycin. 8 As techniques of administration and drug doses differ significantly, we sought to review the literature to provide an overview of the various methods of bleomycin use in the treatment of non-genital warts.…”