Abstract

FLAGELLATE DERMATITIS DUE TO BLEOMYCIN CHEMOTHERPY: A CASE REPORT

Dr. Dhruva Bhat*, Dr. Anuradha H. V. and Dr. Mukunda N.

ABSTRACT

Introduction: Flagellate dermatitis is a cutaneous eruption with a characteristic whip like appearance classically related to the use of bleomycin, a cytotoxic drug. It was first reported in 1970 by Moulin et al. It is considered probably a dose dependent reaction and normally occurs at a cumulative dose of over 100 units. Case description: A 16-year-old female patient with a diagnosis of Germ cell tumor of right ovary was planned for neoadjuvant Bleomycin, Etoposide, Cisplatin (BEP) chemotherapy regimen. Patient was started on Bleomycin (30 units IV on days 1 and 8), Etoposide (150 mg IV on days 1-5) and Cisplatin (30 mg IV on days 1-5). After 2 cycles of chemotherapy, patient developed pruritic linear rashes, with a characteristic whip like appearance over the back, abdomen, flanks, upper and lower limbs. There were no systemic symptoms. The clinical findings and the previous use of bleomycin indicated flagellate dermatitis. Conclusion: Bleomycin induced flagellate dermatitis is a unique adverse effect. The exact pathogenesis of bleomycin‑induced flagellate dermatitis is still unknown but different other theories have been proposed. With declining use of bleomycin, this adverse drug reaction has become infrequent in clinical practice. This underscores the importance of awareness of this dermatological toxicity.

Keywords: Bleomycin, flagellate dermatitis, chemotherapy.