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Image Number 1292 (Flagellate Hyperpigmentation)

 
Morphology:
Hyperpigmentation

Diagnosis: Flagellate Hyperpigmentation

Site: Back

Sex: F

Age: 40

Type:

Description: Linear hyperpigmentation.

Submitted by: Nameer Al-Sudany

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Differential Diagnosis

History: This lady had choriocarcinoma of the genital tract which has been treated with chemotherapy. Bleomycin was one of her treatment regimen. After few doses of bleomycin she developed linear hyperpigmentation on her back. There were many brownish lines which arranged in a haphazard way. ‘Flagellate’ streaked pigmentation on the trunk and proximal extremities is common with bleomycin usage. It has been proposed that trauma from scratching induces localized vasodilatation, with increased concentration of cutaneous bleomycin.

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