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

HISTORY AND CLINICAL FINDINGS

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.

INVESTIGATIONS

Visual diagnosis of a flagellate dermatitis.

TREATMENT AND CLINICAL COURSE

Primary treatment consisted of systemic antihistamines, local and systemic application of steroids. Bleomycin treatment was stopped and substituted by ifosfamide.

CONCLUSION

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.