Bleomycin-induced Flagellated dermatitis: a case report

Abstract

Introduction: Flagellated dermatitis is an infrequent pathology, with characteristic skin lesions, which is developed due to the use of bleomycin. Clinically it occurs as erythematous or hyperpigmented maculae of linear disposition with flagellar pattern, in trunk and/or upper extremities. It presents self-limited evolution, therefore, its treatment varies from expectant management to the use of topical or oral corticosteroids.

Objective: Presentation of a clinical case of flagellated derma titis secondary to bleomycin in a pediatric patient with history of central nervous system neoplasia.

Clinical Case: 8 years, schoolchild, female, with a history of primary intracranial mixed germ cell tumor (sellar and suprasellar) and secondary panhypopituitarism. She receives chemotherapeutic treatment according to the PEB protocol, with use of IV bleomycin during three days. After two days, intermittent pruritus begins, associated with erythematous and pigmented maculae of linear distribution, followed by a flagellated pattern, with isolated signs of excoriation, in the abdominal region and upper back. Topical treatment with mild potency corticosteroids is indicated for ten days, with a satisfactory clinical response.

Conclusions: There should be a high diagnostic suspicion in pediatric patients with a history of prior administration of the drug and the appearance of characteristic skin lesions, which will allow adequate behavior regarding its management and the continuity of chemotherapy.