a 15-year - old boy diagnosed as intracranial germ cell tumor underwent surgery , followed by cranial radiotherapy ( 45 gy ) and later treated with bleomycin , etoposide and cisplatin(bep ) regimen . after third cycle of chemotherapy , he developed asymptomatic erythematous rashes over the back , chest and thighs , which later subsided with persistence of hyperpigmentation [ figure 1 ] . hyperpigmentation of flagellate erythematous rash over the back and thigh bleomycin is a chemotherapeutic antibiotic associated with various skin related toxicities such as raynaud 's phenomenon , flagellate erythema , and sclerodermoid reaction . in the acute stage they are erythematous rashes later may persist as hyperpigmentation marks . other conditions which may be associated with flagellate erythema are docetaxel , adult still 's disease , dermatomyositis and ingestion of shiitake mushrooms . during the acute phase , topical with or without oral steroids