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Pruritic Erythematous Linear Plaques on the Neck and Back

Pruritic Erythematous Linear Plaques on the Neck and Back Abstract REPORT OF A CASE A 43-year-old homemaker with recently diagnosed immunoblastic lymphoma, stage III-A, and chronic active hepatitis, who had recently completed her second cycle of chemotherapy (including bleomycin sulfate, doxorubicin hydrochloride, cyclophosphamide, vincristine sulfate, and prednisone), presented with a markedly pruritic eruption over the neck and back. Lesions first developed on the patient's neck and were described as "papular" and "vesicular"; subsequently the eruption spread to a large area of the back and consisted of large, brightly erythematous linear plaques and patches. There were no aggravating or alleviating factors.Physical examination revealed circumscribed wide linear erythematous plaques and patches located over the posterior aspect of the patient's neck (Fig 1) and lower part of the back (Fig 2). There was no evidence of scale or atrophy. Results of the remainder of skin and mucous membranes examination were unremarkable.What is your diagnosis? DIAGNOSIS: "Flagellate" erythema secondary to bleomycin therapy. References 1. Cohen IS, Mosher MB, O'Keefe EJ, et al: Cutaneous toxicity of bleomycin therapy . Arch Dermatol 1973;107:553-555.Crossref 2. Bronner A, Hood AF: Cutaneous complications of chemotherapeutic agents . J Am Acad Dermatol 1983;9:645-663.Crossref 3. Guillet G, Guillet MH, Meaux H, et al: Cutaneous pigmented stripes and bleomycin treatment . Arch Dermatol 1986;122:381-382.Crossref 4. Yagoda A, Mukherji B, Young C: Bleomycin, an antitumor antibiotic: Clinical experience in 274 patients . Ann Intern Med 1972;77:861-870.Crossref 5. Perrot H, Ortonne JP: Hyperpigmentation after bleomycin therapy: Ultrastructural study . Arch Dermatol Res 1978;261:245-252.Crossref 6. Fernandez-Obregon AC, Hogan KP, Bibro MK: Flagellate pigmentation for intrapleural bleomycin . J Am Acad Dermatol 1985;13:464-468.Crossref 7. Werner Y, Tornberg B: Cutaneous side effects of bleomycin therapy . Acta Derm Venereol 1978;56:155-158. 8. Dantzig PI: Immunosuppressive and cytotoxic drugs in dermatology . Arch Dermatol 1974;110:393-406.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Pruritic Erythematous Linear Plaques on the Neck and Back

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References (9)

Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1987.01660270135034
Publisher site
See Article on Publisher Site

Abstract

Abstract REPORT OF A CASE A 43-year-old homemaker with recently diagnosed immunoblastic lymphoma, stage III-A, and chronic active hepatitis, who had recently completed her second cycle of chemotherapy (including bleomycin sulfate, doxorubicin hydrochloride, cyclophosphamide, vincristine sulfate, and prednisone), presented with a markedly pruritic eruption over the neck and back. Lesions first developed on the patient's neck and were described as "papular" and "vesicular"; subsequently the eruption spread to a large area of the back and consisted of large, brightly erythematous linear plaques and patches. There were no aggravating or alleviating factors.Physical examination revealed circumscribed wide linear erythematous plaques and patches located over the posterior aspect of the patient's neck (Fig 1) and lower part of the back (Fig 2). There was no evidence of scale or atrophy. Results of the remainder of skin and mucous membranes examination were unremarkable.What is your diagnosis? DIAGNOSIS: "Flagellate" erythema secondary to bleomycin therapy. References 1. Cohen IS, Mosher MB, O'Keefe EJ, et al: Cutaneous toxicity of bleomycin therapy . Arch Dermatol 1973;107:553-555.Crossref 2. Bronner A, Hood AF: Cutaneous complications of chemotherapeutic agents . J Am Acad Dermatol 1983;9:645-663.Crossref 3. Guillet G, Guillet MH, Meaux H, et al: Cutaneous pigmented stripes and bleomycin treatment . Arch Dermatol 1986;122:381-382.Crossref 4. Yagoda A, Mukherji B, Young C: Bleomycin, an antitumor antibiotic: Clinical experience in 274 patients . Ann Intern Med 1972;77:861-870.Crossref 5. Perrot H, Ortonne JP: Hyperpigmentation after bleomycin therapy: Ultrastructural study . Arch Dermatol Res 1978;261:245-252.Crossref 6. Fernandez-Obregon AC, Hogan KP, Bibro MK: Flagellate pigmentation for intrapleural bleomycin . J Am Acad Dermatol 1985;13:464-468.Crossref 7. Werner Y, Tornberg B: Cutaneous side effects of bleomycin therapy . Acta Derm Venereol 1978;56:155-158. 8. Dantzig PI: Immunosuppressive and cytotoxic drugs in dermatology . Arch Dermatol 1974;110:393-406.Crossref

Journal

Archives of Dermatology – American Medical Association

Published: Mar 1, 1987

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