Flagellate Hyperpigmentation Following Intralesional Bleomycin Treatment of Verruca Plantaris

Abess, Alexander; Keel, Douglas M.; Graham, Brad S.

doi:10.1001/archderm.139.3.337

Cited by 79 publications

(66 citation statements)

References 20 publications

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“…Although it usually appears after a cumulative dose >100 U; it has also been reported after doses as small as 14 U used for intralesional injections of verrucae. [6] The pathogenesis of bleomycin dermatitis remains speculative and various theories such as micro-trauma, inflammatory oncotaxis, increased melanogenesis, heat-recall and reduced epidermal turnover allowing prolonged melanocyte-keratinocyte contact have been proposed. [4,7,8] There is no specific treatment, but avoidance of bleomycin leads to eventual clearance over months to years.…”

Section: Chemotherapy Induced Fl Agellate Dermatitis and Pigmentationmentioning

confidence: 99%

Flagellate dermatoses

Bhushan¹,

Manjul²,

Baliyan³

2014

Indian J Dermatol Venereol Leprol

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Section: Chemotherapy Induced Fl Agellate Dermatitis and Pigmentationmentioning

confidence: 99%

Flagellate dermatoses

Bhushan¹,

Manjul²,

Baliyan³

2014

Indian J Dermatol Venereol Leprol

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“…93,175,176 Bleomycin may also cause lymphangitis and flagellate hyperpigmentation. 1,177 A double-blind, placebo-controlled study of warts recalcitrant twice to conventional treatments compared one to two intralesional injections of bleomycin to injections of normal saline. Plantar warts (60%), periungual warts (94%) and warts elsewhere on the extremities (95%) were cleared.…”

Section: Antimitotic Therapymentioning

confidence: 99%

An Armamentarium of Wart Treatments

Lipke¹

2006

Clinical Medicine & Research

282

295

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Patients and clinicians experience the frustration of cutaneous viral warts caused by infection with the human papilloma virus (HPV).Warts appear in various forms on different sites of the body and include common warts (verruca vulgaris), plane or flat warts, myrmecia, plantar warts, coalesced mosaic warts, filiform warts, periungual warts, anogenital warts (venereal or condyloma acuminata), oral warts and respiratory papillomas. Cervical infection with HPV is now known to cause cervical cancer if untreated. A review of the medical literature reveals a huge armamentarium of wart monotherapies and combination therapies. Official evidence-based guidelines exist for the treatment of warts, but very few of the reported treatments have been tested by rigorous blinded, randomized controlled trials.Therefore, official recommendations do not often include treatments with reportedly high success rates, but they should not be ignored when considering treatment options. It is the purpose of this review to provide a comprehensive overview of the wart treatment literature to expand awareness of the options available to practitioners faced with patients presenting with problematic warts. Warts of the genital tract carry a much more ominous and pernicious threat for women in particular. It has been estimated that up to 70% of sexually active women become infected during their lifetime with human papillomavirus (HPV), the infective agent that causes warts. 3-5 A causal role for HPV infections in cervical cancer has been documented beyond reasonable doubt. HPV DNA is present in virtually all cervical cancer cases worldwide, with it being detected in 99.7% of an international series of cervical cancers by genetic amplification techniques and in 100% of cases as confirmed by histological review. 6,7 Cervical cancer is the most frequent common cancer in developing countries and the second most common cancer in women worldwide. 3 The association between HPV infection and cervical cancer is so strong that HPV is now considered the first positive cause of any human cancer ever identified. 3This raises the level of concerns over HPV prevention, screening and treatment from that of a nuisance condition to that of a major public health concern. Attention is beginning to focus on the viral factors that determine persistence and neoplastic progression to cancer and the possible role of HPV in other nongenital cancers (e.g., skin, upper aerodigestive tract). [8][9][10][11][12][13][14][15][16][17] Patients with warts seek advice from general practitioners, pharmacists, naturopaths, allied health professionals, family or friends, dermatologists, gynecologists, obstetricians and pediatricians for treatment and may present with recalcitrant warts that have been previously treated with anything from folk remedies to hypnosis to over-the-counter medications to more aggressive clinic-based treatments. Unfortunately, even with years of medical literature on this subject, high-quality, level I evidence for the efficacy of almost all treatments is no...

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“…106,107 The major side-effect of bleomycin is pain at the time of injection and for up to 48 h afterwards. Flagellate hyperpigmentation, which may occur with standard systemic chemotherapy, has also been reported, 108 as has postinflammatory pigmentation, which usually clears after some weeks. 1 Topical retinoids (level of evidence 2+; strength of recommendation C).…”

mentioning

confidence: 99%