Flagellate erythema induced by bleomycin toxicity
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 [].\nBleomycin 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 may reduce symptoms.