Hyperpigmentation after bleomycin therapy

Perrot, H; Ortonne, Jean‐Paul

doi:10.1007/bf00455292

Cited by 20 publications

(7 citation statements)

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“…These changes were similar to those seen in previous ultrastruc tural studies [4,8]. There was also some degree of pigmen tary incontinence, such as occurs in post-inflammatory yperpigmentation.…”

Section: Discussionsupporting

confidence: 77%

Reticulate Pigmentation due to Bleomycin: Light- and Electron-Microscopic Studies

1990

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An unusual case of extensive reticulate pigmentation due to bleomycin is reported. Light- and electron-microscopic studies showed a marked increase of melanin pigment in the basal keratinocytes and a number of melanophages in the upper dermis. The number of melanocytes appeared to be normal. Electron microscopy also revealed damage to subcellular organelles. The increase in pigmentation is thought to be a consequence of this focal damage.

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Section: Discussionsupporting

confidence: 77%

Reticulate Pigmentation due to Bleomycin: Light- and Electron-Microscopic Studies

1990

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“…The pathological findings reveal an increased epidermal pigmentation with active melanocytes and many melanosomal complexes in keratinocytes with some degree of pigment incontinence. 13 , 14 , 16 , 18 Additional studies are required to determine the cause of the pruritus and to explain the linear pattern of the skin lesions following bleomycin therapy.…”

Section: Discussionmentioning

confidence: 99%

Bleomycin‐induced urticarial flagellate drug hypersensitivity reaction

et al. 1999

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New York, NY 10022[TAB]A 70‐year‐old woman was found to have an infiltrating ductal carcinoma of the right breast in July 1992, for which she underwent a modified radical mastectomy and was started on tamoxifen. In May 1995, she presented with metastasis to the right lung and ribs. The patient received 60 mg of bleomycin intrapleurally, and was started on leucovorin, 5‐fluorouracil and mitoxantrone. One week following the administration of chemotherapy, she developed pruritic erythematous indurated dermal papules and plaques, arranged in a linear configuration over the face, trunk and extremities ( Fig. 1). The patient is right‐handed. Two skin biopsy specimens, obtained from the forehead and right anterior chest, exhibited similar histopathologic features. Beneath focal areas of parakeratosis, the dermis displayed papillary dermal edema and superficial and deep perivascular and interstitial mixed inflammatory cell infiltrate composed of lymphocytes, neutrophils and eosinophils (Fig. 2). These findings were consistent with an urticarial allergic drug hypersensitivity reaction. The eruption resolved over a period of 1 month leaving residual linear and flagellate hyperpigmentation. 1 Flagellate erythema over the back 2 Perivascular and interstitial mixed inflammatory cell infiltrate(× magnification)[TAB]

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“…1). Analysis of electron microscopy demonstrated increased melanogenesis within the melanocytes and many melanosomal complexes in the surrounding keratinocytes, 10,29,33 and the presence of intracytoplasmic vacuoles in the epidermis that probably resulted from damage to mitochondria 29 . There have been several speculations: the hyperpigmentation is postinflammatory; 11 bleomycin reduces the epidermal turnover and prolonged contact between melanocytes and keratinocytes; 10 bleomycin slows down the turnover of the keratinocytes with relative blockage of melanocytes in the phase of pigment synthesis; 12 and accumulation of bleomycin in the skin causes a subsequent fixed drug eruption owing to the direct effects of bleomycin on keratinocytes 13 .…”

Section: Bleomycin‐induced Flagellate Erythemamentioning

confidence: 99%