Flagellate Erythema Research Articles

A Young Girl with Bleomycin-Induced Flagellate Erythema

A Young Girl with Bleomycin-Induced Flagellate Erythema

Flagellate dermatitis in a patient with testicular germ cell neoplasia on bleomycin.

Bleomycin, an antineoplastic antibiotic that inhibits DNA synthesis, is used to treat various malignant tumors such as Hodgkin's lymphoma, squamous cell carcinoma, and germ cell tumors. Flagellate erythema is a rare rash with a linear pattern that has been observed in association with bleomycin treatment. Herein, we present a 43-year-old patient with metastatic testicular cell neoplasms who developed a whiplash rash during treatment with a chemotherapy regimen that included bleomycin. A typical case of bleomycin-related flagellate dermatitis has been diagnosed and the main features of this characteristic adverse drug event are briefly discussed.

Interleukin-1/6 Blockade for the Treatment of Severe Steroid-Refractory BNT162b2 Vaccine-Induced Adult-Onset Still's Disease.

IntroductionSeveral immune-mediated side effects have been reported with COVID-19 vaccines, including myocarditis.Case descriptionA 27-year-old woman with a past medical history of mild COVID-19, developed adult-onset Still’s disease (AOSD) with salmon-pink flagellate erythema, polyarthritis, a sore throat, myocarditis and haemophagocytic lymphohistiocytosis after receiving two doses of the BNT162b2 vaccine (Pfizer®, BioNTech®). Despite the initial efficacy of high-dose pulses of methylprednisolone, inflammatory markers rose as soon as de-escalation of corticosteroids was attempted, warranting initiation of biologics targeting the interleukin (IL)-1/6 axis, which allowed sustained remission of the disease despite withdrawal of corticosteroids.DiscussionTo our knowledge, this is the first case of AOSD with both haemophagocytic lymphohistiocytosis and cardiac magnetic resonance imaging-proven myocarditis triggered by COVID-19 vaccination, successfully treated with steroids and biologics targeting the IL-1/IL-6 axis. The pathophysiological process by which COVID-19 vaccination can lead to AOSD is still unknown, although it has been reported that the spike protein may act as a pathogen-associated molecular pattern and thus induce an overproduction of pro-inflammatory cytokines of the innate immune system (e.g., IL-1, IL-6 or IL-18).ConclusionTargeting the IL-1/6 axis is effective for the treatment of severe steroid-refractory BNT162b2 vaccine-induced adult-onset Still’s disease. At a population level, the favourable benefit/risk ratio of COVID-19 vaccination remains indisputable.LEARNING POINTSAdult-onset Still’s disease can be triggered by the BNT162b2 COVID-19 vaccine.Biologics targeting the interleukin-1/6 axis should be considered early in the course of vaccine-induced adult-onset Still’s disease, especially when steroids do not effectively curb the disease.

Boletus dermatitis: first report in France of flagellate erythema after consumption of Porcini mushrooms

Boletus dermatitis: first report in France of flagellate erythema after consumption of Porcini mushrooms

Flagellate Erythema: A Case of Shiitake Dermatitis and Review of Pathogenesis

Shiitake dermatitis is a rare eruption that is associated with the ingestion of uncooked shiitake mushrooms, resulting in a distinctive flagellate erythema. It was initially hypothesised that the mechanism of disease related to a toxic reaction to lentinan; however, recent evidence has suggested a potential allergic mechanism. The authors herein present a case of shiitake dermatitis and review the current understanding of pathogenesis of this condition and flagellate morphology. With an increase in consumption of shiitake mushrooms in Western society, shiitake dermatitis is expected to become more prevalent worldwide.

Flagellate Erythema: A Case of Shiitake Dermatitis and Review of Pathogenesis

Shiitake dermatitis is a rare eruption that is associated with the ingestion of uncooked shiitake mushrooms, resulting in a distinctive flagellate erythema. It was initially hypothesised that the mechanism of disease related to a toxic reaction to lentinan; however, recent evidence has suggested a potential allergic mechanism. The authors herein present a case of shiitake dermatitis and review the current understanding of pathogenesis of this condition and flagellate morphology. With an increase in consumption of shiitake mushrooms in Western society, shiitake dermatitis is expected to become more prevalent worldwide.

Flagellate Erythema Secondary to Bleomycin for Non-Seminomatous Testis Tumor

The development of flagellate erythema secondary to bleomycin treatment is a rare adverse effect. The prevalence varies between 8 to 22% of patients and it is becoming rarer. Flagellate erythema presents as a scaly erythematous papule. A lower amount of bleomycin hydrolase in regions with reduced production, such as skin and lungs, decreases bleomycin degradation, which allows its accumulation in tissues, triggering an inflammatory process, especially in patients with lower basal enzyme function. We report a clinical case of a severe presentation of flagellate erythema secondary to a patient ongoing bleomycin, etoposide and platinum (BEP) based chemotherapy of non-seminomatous testis cancer.

Covert clues: the non-hallmark cutaneous manifestations of dermatomyositis.

Dermatomyositis (DM) is a strikingly heterogenous disease characterized by a broad and ever-evolving spectrum of cutaneous manifestations that transcend the classic “hallmarks” defined by Peter and Bohan in 1975. Despite the increasing preponderance and ubiquity of autoantibody, radiologic, and electrophysiologic testing, the diagnosis of DM still hinges largely on prompt detection of cutaneous manifestations of this condition. While pathognomonic cutaneous features of DM are more readily recognizable, many patients present with subtle and/or atypical skin manifestations, and diagnosis of DM may require clinician identification of these cutaneous clues. In this review, we highlight several of the lesser-known skin manifestations of DM, specifically, panniculitis, diffuse subcutaneous edema, erythroderma, calcinosis, ulceration, flagellate erythema, Wong-type DM, gingival telangiectasias, and the ovoid palatal patch. We describe the clinical and histopathologic presentation of these cutaneous findings. While manifesting less frequently than the heliotrope rash, Gottron’s papules, and Gottron’s sign, these cutaneous clues are equally important for clinicians to recognize in order to facilitate timely diagnosis and early intervention.

Bleomycin-induced flagellate erythema in a patient with germ cell tumor

Bleomycin-induced flagellate erythema in a patient with germ cell tumor

A Case of Rash with Flagellate Erythema and Muscle Weakness: Another Example of Dermatomyositis

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Drug eruptions associated with tumor therapy: Great imitators

Many studies have investigated cutaneous reactions to antitumor drugs and found them to be quite numerous. We describe drug eruptions that may be associated with different therapies by class: antimetabolite chemotherapeutics, genotoxic agents, spindle inhibitors, signal transduction inhibitors, and immunotherapies. Methotrexate is most often associated with mucocutaneous reactions, alkylating antimetabolite agents with hyperpigmentation, and platinum antimetabolite agents with type I IgE-mediated hypersensitivity reactions. Anthracycline derivatives can induce the hand-foot syndrome in patients, and bleomycin is associated with a bleomycin-induced flagellate erythema. Taxane spindle inhibitors can result in acneiform eruptions, which may also be seen with use of epidermal growth factor receptor inhibitors. Imatinib and its derivatives can cause a truncal maculopapular eruption, whereas multikinase inhibitors can produce a hand-foot-skin reaction. Vemurafenib can result in squamous cell carcinomas and photosensitivity. First-generation mammalian target of rapamycin inhibitors may cause a maculopapular eruption initially involving the face and neck. Programmed death (PD)-1-ligand and receptor inhibitors are associated with bullous pemphigoid. Ipilimumab, targeting Cytotoxic -T- Lymphocyte- associated (CTLA-4) receptors, can cause a morbilliform reaction, whereas Interleukin -2 (IL-2) analogs can create the capillary leak syndrome. Chemotherapeutic drug eruptions classically can manifest in the aforementioned ways; however, it is important to understand that they are associated with myriad cutaneous adverse effects, which may be mistaken for organic skin disease. Oncologists prescribing these medications should be familiar with the cutaneous side effects of these medications, and so they may counsel patients to be on the lookout for them.

A case of bleomycin-induced flagellate erythema

A case of bleomycin-induced flagellate erythema

18. Flagellate erythema: A clinicopathologic study of 3 cases and systematic review of the literature

18. Flagellate erythema: A clinicopathologic study of 3 cases and systematic review of the literature

Flagellate erythema as a bleomycin: specific adverse effect

La bléomycine est un antibiotique antitumoral. Elle peut être responsable d'effets secondaires variables en particulier cutanés et pulmonaires. Certains sont rares, mais spécifiques de la bléomycine. Nous rapportons l'observation de deux malades âgés respectivement de 35 et 38 ans ayant présentés une toxidermie à la bléomycine a type d'érythème flagellé après administration de bléomycine pour un choriocarcinome et un lymphome malin non hodgkinien L'érythème flagellé est spécifique de la bléomycine, il complique 10 à 30% des traitements dans un délai de quelques heures à 9 semaines. Il est indépendant de la dose, de la voie d'administration et de la nature de la lésion traitée. Ces lésions apparaissent après une dose cumulative de 90 à 285 mg. Cliniquement, il s'agit de bandes linéaires avec un aspect flagellé prédominantes sur tout le tronc et les parties proximales des membres. L'éthiopathogénie est incertaine. L'évolution est marquée par une résolution spontanée des lésions à l'arrêt du traitement parfois au prix d'une pigmentation linéaire cicatricielle, ou une sclérose résiduelle.The bléomycine is an antitumor antibiotic. It can be responsible for in particular cutaneous and pulmonary variable side effects. Some are rare, but specific of the bléomycine. We report the observation of two patients aged respectively of 35 and 38 years old, having presented a toxidermy at the bléomycine has standard erythema whipped after administration of bléomycine for a choriocarcinomist and a malignant lymphoma not hodgkinien the whipped erythema is specific of bléomycine, it complicates 10 to 30% of the treatments within a few hours to 9 weeks. It is independent of the amount, the route of administration and the nature of the treated lesion. These lesions appear after a cumulative amount from 90 to 285 Mg. Clinically, they are linear bands with an aspect whipped prevalent on all the trunk and the proximales parts of the members. The éthiopathogénie is dubious. The evolution is marked by a spontaneous resolution of the lesions to the stop of the treatment sometimes the price of a cicatricial linear pigmentation, or a residual sclerosis.

Flagellate Erythema in a Case of Paraneoplastic Dermatomyositis.

Flagellate Erythema in a Case of Paraneoplastic Dermatomyositis.

Flagellate erythema induced by cisplatin

Flagellate erythema induced by cisplatin

Bleomycin Containing Chemotherapeutic Regimen Induced Acquired Partial Lipodystrophy.

Bleomycin toxicity predominantly affects the skin and lungs. Cutaneous toxicity classically known to present with bleomycin are flagellate erythema and drug rash. We hereby report an isolated case of (bleomyicn)-induced acquired partial (lipodytrophy) having potential cosmetic implications in a young women prescribed postoperatively following a case of germ cell carcinoma of ovary (endodermal sinus tumor).

Trastuzumab-Associated Flagellate Erythema: Report in a Woman with Metastatic Breast Cancer and Review of Antineoplastic Therapy-Induced Flagellate Dermatoses.

IntroductionFlagellate erythema presents as erythematous, individual and intermingled, linear streaks in a whiplash-like pattern. Several conditions, including antineoplastic agents, have been associated with flagellate erythema. A woman with metastatic breast cancer who developed flagellate erythema after receiving trastuzumab is described and the features of flagellate erythema associated with other antineoplastic agents are reviewed.MethodsPubMed was used to search the following terms, separately and in combination: agent, antineoplastic, bendamustine, bleomycin, breast, cancer, chemotherapy, dermatitis, dermatosis, docetaxel, erythema, flagellate, Herceptin, pigmentation, peplomycin, therapy, and trastuzumab. All papers were reviewed and relevant manuscripts, along with their reference citations, were evaluated.ResultsThe woman’s pruritus and skin lesions promptly resolved after treatment with corticosteroids (oral and topical) and antihistamines (oral); premedication with dexamethasone prior to each subsequent trastuzumab treatment prevented recurrence of flagellate erythema. Chemotherapy-induced flagellate erythema was initially described in oncology patients who received bleomycin. In addition to trastuzumab, other antineoplastic agents that have been associated with the development of flagellate erythema include bendamustine, docetaxel, and peplomycin.ConclusionCutaneous adverse events to trastuzumab are uncommon. However, flagellate erythema should be added to the potential side effects of trastuzumab. In addition, trastuzumab should be added to the list of antineoplastic agents that may be associated with flagellate erythema.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-015-0085-2) contains supplementary material, which is available to authorized users.

Bleomycin-Induced Flagellate Erythema in a Patient Diagnosed with Ovarian Yolk Sac Tumor.

Flagellate linear hyperpigmentation can rarely be caused by the chemotherapy agent, bleomycin. Herein, we describe the case of a 20-year-old woman treated with bleomycin for an ovarian yolk sac tumor and review the prominent features of this form of dermatitis.

Bleomycin-induced Flagellate Erythema: A Rare and Unique Drug Rash.

Bleomycin-induced flagellate erythema is a rare rash associated with the use of the drug. The rash has a characteristic and intermingled lacy appearance as if it has been whipped. Lack of detoxifying enzymes for bleomycin in the skin makes it a vulnerable site for the adverse effects of bleomycin, along with the lungs. We report the case of young girl with germ cell tumour who developed bleomycin-induced flagellate erythema.