Stevens G Jonathan, Dossi C María Teresa, Muñoz M Gianna
Departamento de Dermatología, Facultad de Medicina, Universidad de Chile, Chile.
Servicio de Dermatología, Hospital Luis Calvo Mackenna, Chile.
Rev Chil Pediatr. 2018 Apr;89(2):257-260. doi: 10.4067/S0370-41062018000200257. Epub 2018 Apr 4.
Flagellated dermatitis is an infrequent pathology, with characteristic skin lesions, which is developed due to the use of bleomycin. Clinically it occurs as erythematous or hyperpigmented maculae of linear disposition with flagellar pattern, in trunk and/or upper extremities. It presents self-limited evolution, therefore, its treatment varies from expectant management to the use of topical or oral corticosteroids.
Presentation of a clinical case of flagellated dermatitis secondary to bleomycin in a pediatric patient with history of central nervous system neoplasia.
8 years, schoolchild, female, with a history of primary intracranial mixed germ cell tumor (sellar and suprasellar) and secondary panhypopituitarism. She receives chemotherapeutic treatment according to the PEB protocol, with use of IV bleomycin during three days. After two days, intermittent pruritus begins, associated with erythematous and pigmented maculae of linear distribution, followed by a flagellated pattern, with isolated signs of excoriation, in the abdominal region and upper back. Topical treatment with mild potency corticosteroids is indicated for ten days, with a satisfactory clinical response.
There should be a high diagnostic suspi cion in pediatric patients with a history of prior administration of the drug and the appearance of characteristic skin lesions, which will allow adequate behavior regarding its management and the continuity of chemotherapy.
鞭毛状皮炎是一种罕见的病症,具有特征性皮肤损害,是由于使用博来霉素所致。临床上表现为躯干和/或上肢出现呈线状分布、具有鞭毛样形态的红斑或色素沉着斑。其病程呈自限性,因此,治疗方法从观察处理到使用外用或口服糖皮质激素不等。
介绍一例继发于博来霉素的鞭毛状皮炎临床病例,患儿有中枢神经系统肿瘤病史。
一名8岁学龄女童,有原发性颅内混合性生殖细胞瘤(鞍区和鞍上)及继发性全垂体功能减退病史。她按照PEB方案接受化疗,静脉使用博来霉素3天。两天后,腹部和上背部开始出现间歇性瘙痒,伴有线状分布的红斑和色素沉着斑,随后呈现鞭毛样形态,有孤立的搔抓痕迹。给予外用低效糖皮质激素治疗10天,临床反应良好。
对于有用药史且出现特征性皮肤损害的儿科患者,应高度怀疑此病,这将有助于对其进行适当处理并继续进行化疗。