Cullingham Kyle, Kost Gregory
Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
University of Saskatchewan, Saskatoon, SK, Canada.
SAGE Open Med Case Rep. 2021 Aug 31;9:2050313X211039476. doi: 10.1177/2050313X211039476. eCollection 2021.
The article description and significance to dermatologists: bleomycin flagellate dermatitis is a rare cutaneous manifestation, believed to be due to the lack of bleomycin hydrolase enzyme in the skin, which inactivates bleomycin, resulting in its accumulation. This is thought to be a dose-dependent reaction, and doses over 200 U and higher may increase risk. This case describes a male developing a pruritic, erythematous linear flagellated dermatitis to the lower back after his third cycle of bleomycin, etoposide and cisplatin for a stage 3 seminoma. Pruritis resolved and erythema improved with the treatment of bilastine and desoximetasone cream. It is important to recognize this condition because untreated pruritis may lead to increased impairment of the skin barrier in already immunocompromised patient populations. This may also give further evidence to having ongoing and continuing collaboration between Dermatology and Medical Oncology for any patients presenting with a new rash undergoing chemotherapy treatments.
博来霉素鞭毛虫样皮炎是一种罕见的皮肤表现,据信是由于皮肤中缺乏使博来霉素失活的博来霉素水解酶,导致其蓄积。这被认为是一种剂量依赖性反应,超过200单位及更高剂量可能会增加风险。该病例描述了一名男性在接受博来霉素、依托泊苷和顺铂联合治疗第三周期用于治疗Ⅲ期精原细胞瘤后,下背部出现瘙痒性、红斑性线性鞭毛虫样皮炎。使用比拉斯汀和去氧米松乳膏治疗后瘙痒缓解,红斑改善。认识到这种情况很重要,因为在已经免疫功能低下的患者群体中,未经治疗的瘙痒可能会导致皮肤屏障功能进一步受损。这也可能为皮肤科和医学肿瘤学之间针对任何接受化疗且出现新发皮疹的患者进行持续合作提供进一步证据。