Bleomycin-induced flagellate pigmentation: a case report from North-East India

<p class="abstract">Bleomycin is an antitumour antibiotic commonly used in the management of Hodgkin’s lymphoma and germ cell tumours. Flagellate pigmentation is a very specific and rare cutaneous adverse effect of bleomycin. It is characterised by linear, painless, pruritic, hyperpigmented lesions simulating marks of whiplashes over trunk and extremities. With the advent of targeted therapies resulting in the infrequent use of bleomycin, this unique side effect is also uncommonly encountered nowadays. Here, we report a case of bleomycin-induced flagellate pigmentation in a 35-year-old Indian female with ovarian teratoma. The characteristic patterned hyperpigmented patches developed following 2nd cycle of chemotherapy with bleomycin, etoposide and cisplatin.</p><p class="abstract"> </p>

Gemcitabine-induced skin necrosis

Since its emergence as a chemotherapy agent, gemcitabine has been associated with cutaneous adverse reactions. Rash is reported to be the most common cutaneous adverse effect. Other reported cutaneous reactions in the literature include bullous dermatosis, pseudocellulitis, subacute cutaneous lupus alopecia, and palmar–plantar erythrodysesthesia. Skin necrosis is a very rare adverse effect of this otherwise well-tolerated chemotherapeutic agent. In searching the literature, only one other case has been reported. In our report, we present a 74-year-old male with adenocarcinoma of the pancreas, status-post pancreaticoduodenectomy (Whipple procedure), who developed a rare case of skin necrosis of the lower leg 2 weeks after completing six cycles of monotherapy gemcitabine treatment.