Schummer C, Winkler Y, Tittelbach J, Grimm M-O, Elsner P
Klinik für Hautkrankheiten, Universitätsklinikum Jena.
Klinik für Urologie, Universitätsklinikum Jena.
Dtsch Med Wochenschr. 2014 Jan;139(3):84-6. doi: 10.1055/s-0033-1359878. Epub 2014 Jan 7.
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.
一名49岁患有恶性生殖细胞肿瘤的患者在接受首个周期的PEB（顺铂[P]、依托泊苷[E]和博来霉素[B]）治疗时，出现了伴有散在水疱的瘙痒性线状丘疹红斑。皮疹于三天前出现，即在第二次使用博来霉素四天后出现。
临床诊断为鞭毛虫性皮炎。
初始治疗包括全身应用抗组胺药、局部及全身应用类固醇。停止博来霉素治疗，换用异环磷酰胺。
博来霉素治疗后鞭毛虫性皮炎的发生率高达66%。博来霉素剂量与皮损的发生率或严重程度之间无关联。鞭毛虫性皮炎是一种自限性疾病，但色素沉着可能持续存在。苯达莫司汀、多西他赛、食用未充分煮熟的香菇以及皮肌炎和斯蒂尔综合征也可能出现类似皮损。
