Bleomycin-induced Flagellate Dermatitis: a Case Report

Flagellate dermatitis represents a unique cutaneous eruption associated with several causes, including treatment with certain chemotherapeutic agents, ingestion of toxins and rheumatologic conditions like adult-onset Still’s disease and dermatomyositis. We present the case of a 35-year-old woman with stage IIA Hodgkin lymphoma who was treated with the ABVD chemotherapy regimen (doxorubicin, bleomycin, vinblastine and dacarbazine). During the third cycle of chemotherapy, she developed multiple linear erythematous macules and hyperpigmentation in a striking flagellate-like pattern localized on the upper chest, submammary folds, neck and upper part of the back. The lesions resolved completely within three months after the withdrawal of bleomycin. Clinicians should be aware of this distinctive cutaneous toxicity in patients receiving bleomycin combination chemotherapy.