博来霉素诱导的皮肤毒性：是否总是鞭笞状红斑？
Bleomycin-induced skin toxicity: is it always flagellate erythema?
作者信息
Verma Shailendra Prasad, Subbiah Arunkumar, Kolar Vishwanath Vinod, Dutta Tarun Kumar
机构信息
Department of Clinical Haematology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
出版信息
BMJ Case Rep. 2016 Sep 29;2016:bcr2014204575. doi: 10.1136/bcr-2014-204575.
Bleomycin-induced skin toxicity is a rare and unique complication. We report a 35-year-old man with nodular lymphocytic predominant Hodgkin's lymphoma, stage IVB, who was started on adriamycin, bleomycin, vinblastin and dacarbazine (ABVD) chemotherapy. He developed pruritic hyperpigmented, patchy skin lesions on the neck, back, chest and thighs after IA cycle of ABVD chemotherapy. Lesions were not typical flagellate rash but hyperpigmented, patchy and mildly pruritic lesions over the trunk and proximal extremities. Lesions increased with continuation of bleomycin and improved gradually after removing the drug from chemotherapy schedule. The patient was in complete remission after VI cycles of chemotherapy (AVD Regimen) and skin lesions healed with minimal residual hyperpigmentation.
博来霉素诱导的皮肤毒性是一种罕见且独特的并发症。我们报告一名35岁的男性，患有IVB期结节性淋巴细胞为主型霍奇金淋巴瘤，开始接受阿霉素、博来霉素、长春花碱和达卡巴嗪（ABVD）化疗。在ABVD化疗的第1周期后，他的颈部、背部、胸部和大腿出现了瘙痒性色素沉着、斑片状皮肤病变。病变并非典型的鞭状皮疹，而是躯干和近端肢体上色素沉着、斑片状且轻度瘙痒的病变。随着博来霉素的持续使用，病变增多，在从化疗方案中停用该药物后逐渐改善。该患者在接受6个周期的化疗（AVD方案）后完全缓解，皮肤病变愈合，仅残留少量色素沉着。
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