Bleomycin‐induced flagellate dermatitis in AIDS patients with Kaposi's sarcoma

Objective To describe and illustrate bleomycin‐induced cutaneous toxicity, which may present atypically in AIDS patients with Kaposi's sarcoma. Design and subjects Case note review of all AIDS patients receiving systemic chemotherapy in the preceding year. Setting Combined oncology and HIV out‐patient clinic at the Chelsea and Westminster Hospital in London. Outcome measured Cutaneous toxicity associated with intravenous bleomycin therapy. Results We report three cases of bleomycin‐induced flagellate dermatitis with atypical presentation of pruritic skin lesions after relatively low doses of bleomycin. Conclusions Bleomycin usage is increasing as an effective agent in the treatment of AIDS‐related Kaposi's sarcoma. Awareness that cytotoxic drugs may produce a range of unusual cutaneous adverse effects in this patient population is important for doctors of all specialities who treat HIV‐infected patients. The pathomechanism of flagellate dermatitis is discussed.