Three Cases of Flagellate Pigmentation from Intravenous Bleomycin

Cho, Hang Rae; Lee, Mu Hyoung; Haw, Choong Rim

Abstract

Bleomycin is an antitumoral antibiotic derived from Streptomyces verticillus in 1965. The drug has been used with a varying success in the treatment of squamous cell carcinomas and malignant lymphomas. The cutaneous toxicities of bleomycin include hyperpigmentation, sclerosis, gangrene, nail changes and erythema. Linear streaks appear to be a characteristic eruption induced by bleomycin. We report three cases of flagellate pigmentation from intravenous bleomycin. Three patients were suffering from uterine cervical carcinomas and were treated with chemotherapy with a VBP (vincristine, bleomycin, cisplatire) regimen. During or after their courses of chemotherapy, dark brownish skin lesions developed on the body surface of these patients. A Light microscopic study of each specimen showed increased pigmentation of the basal layer and an electron microscopic study showed a slightly increased number of melanosomes in keratinocytes.