Flagellate dermatitis after bleomycin chemotherapy in a patient with malignant germ cell tumor

• Published in: Deutsche medizinische Wochenschrift (1946) Vol. 139; no. 3; p. 84
• Main Authors: Schummer, C, Winkler, Y, Tittelbach, J, Grimm, M-O, Elsner, P
• Format: Journal Article
• Language: German
• Published: Germany 01.01.2014
• Subjects: Antibiotics, Antineoplastic - administration & dosage; Antibiotics, Antineoplastic - adverse effects; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bleomycin - administration & dosage; Bleomycin - adverse effects; Bleomycin - therapeutic use; Cisplatin - adverse effects; Cisplatin - therapeutic use; Drug Eruptions - diagnosis; Drug Substitution; Etoposide - adverse effects; Etoposide - therapeutic use; Humans; Ifosfamide - therapeutic use; Male; Middle Aged; Neoplasm Staging; Neoplasms, Germ Cell and Embryonal - drug therapy; Neoplasms, Germ Cell and Embryonal - pathology; Prednisolone - administration & dosage; Prednisolone - adverse effects; Testicular Neoplasms - drug therapy; Testicular Neoplasms - pathology
• ISSN: 1439-4413
• DOI: 10.1055/s-0033-1359878

A 49-year-old patient with malignant germ cell tumor within the first cycle PEB (platinum [P], etoposid [E] and bleomycin [B]) presented with an itchy linear papular erythema with discrete vesicles. The rash had appeared three days ago i. e. four days after the second application of bleomycin. Visual diagnosis of a flagellate dermatitis. Primary treatment consisted of systemic antihistamines, local and systemic application of steroids. Bleomycin treatment was stopped and substituted by ifosfamide. Flagellate dermatitis occurs with an incidence up to 66 % after bleomycin treatment. There is no association between bleomycin dose and incidence or severity of the lesions. Flagellate dermatitis is a self-limiting condition but hyperpigmentation may persist. Similar lesions may occur with bendamustine and docetaxel, the intake of insufficiently cooked shiitake mushrooms as well as in dermatomyositis and Still's syndrome.