BLEOMYCIN INDUCED FLAGELLATE DERMATITIS IN A PATIENT WITH NON-SEMINOMA GERM CELL TUMOUR WITH BILATERAL UNDESCENDED TESTES

Authors

  • Manzoor Khan Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar-Pakistan
  • Malik Hasnat Ul Hassan Khan Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar-Pakistan
  • Muhammad Firdous Khan Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar-Pakistan
  • Syed Aftab Ahmad Khyber Teaching Hospital Peshawar-Pakistan
  • Sara Baloch Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar-Pakistan
  • Shazia Asim Lahore Medical and Dental College, Lahore-Pakistan
  • Eesha Akhlaque Lahore Medical and Dental College, Lahore-Pakistan

Keywords:

Flagellate Dermatitis, Bleomycin, Non-Seminoma Germ Cell Tumor, Undescended Testes

Abstract

Flagellate Dermatitis (FD) is a rare cutaneous manifestation of bleomycin toxicity caused by the deficiency of bleomycin hydrolase enzyme in the skin. It typically presents as erythematous patches or papules with linear, multiple flagellate structures. In this article, we report the case of FD in a 21-year-old male patient with non-seminoma germ cell tumour presenting with abdominal pain and bilateral undescended testes since birth. The patient was started on the BEP (Bleomycin, Etoposide and Cisplatin) protocol as per institutional guidelines. On the 17th day of the first cycle, the patient developed multiple whiplash skin lesions over his back, shoulders and front right frontotemporal area with intense itching. A diagnosis of FD was made clinically. Bleomycin was stopped and he was switched to etoposide and cisplatin-based chemotherapy for the remaining three cycles. The rashes were treated with topical steroids (Beclomethasone), Systemic steroids (Prednisolone) and antihistamines (Cetrzine) according to recommended protocol. The patient responded very well to the above-mentioned treatment with the rashes completely disappearing within a span of 14 days. This case highlights the need for vigilance during chemotherapy as it can cause a wide range of skin reactions. FD is a condition with multiple potential causes and mechanisms underlying cutaneous manifestations. Early recognition and prompt treatment can help prevent long-term complications and improve patients' quality of life.

Author Biographies

Manzoor Khan, Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar-Pakistan

Senior Instructor, Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar 

Malik Hasnat Ul Hassan Khan, Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar-Pakistan

Medical officer SKMCH Peshawar

Muhammad Firdous Khan, Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar-Pakistan

Medical officer SKMCH Peshawar 

Eesha Akhlaque, Lahore Medical and Dental College, Lahore-Pakistan

Student at Lahore Medical and Dental College

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Published

2024-06-30

How to Cite

Khan, M., Hasnat Ul Hassan Khan, M., Khan, M. F., Ahmad, S. A., Baloch, S., Asim, S., & Akhlaque, E. (2024). BLEOMYCIN INDUCED FLAGELLATE DERMATITIS IN A PATIENT WITH NON-SEMINOMA GERM CELL TUMOUR WITH BILATERAL UNDESCENDED TESTES. Journal of Ayub Medical College Abbottabad, 36(2), 427–429. Retrieved from https://demo.ayubmed.edu.pk/jamc/index.php/jamc/article/view/12206

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