Flagellate hyperpigmentation following intralesional bleomycin treatment of verruca plantaris.
BACKGROUND
Flagellate hyperpigmentation is a well-documented complication of systemic bleomycin sulfate therapy when using doses of 100 U or more as an antineoplastic agent. Two cases occurred after using systemic doses from 15 to 30 U injected intravenously or intrapleurally; however, it has not been described as a complication following intralesional treatment of verruca plantaris.


METHODS
We report a case of flagellate hyperpigmentation after intralesional injection of 14 U of bleomycin for verrucae plantaris and review the literature associated with this cutaneous complication.


CONCLUSIONS
Flagellate hyperpigmentation from extremely low doses of intralesional bleomycin is a previously undescribed complication. Although the mechanisms of reaction are not clearly understood, the clinician should be mindful of this uncommon complication.
Abess
Alexander
A
Department of Dermatology, Naval Medical Center San Diego, San Diego, CA, USA.
Keel
Douglas M
DM
Graham
Brad S
BS
D000005:Abdomen; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced* / Q000473:pathology; D015552:Injections, Intralesional; D014860:Warts / Q000188:drug therapy* / Q000473:pathology
D000903:Antibiotics, Antineoplastic; D001761:Bleomycin