Flagellate Hyperpigmentation in a Scratched Area after Bleomycin for Pleurodesis-A Case Report and Review of the Literature

撲類惡肋膜沾黏術後之發生於全身抓搔處的條紋狀色素沉著症－病例報告與文獻回顧

劉懿珊(Yi-Shan Liu) ； 陳雅惠(Ya-Hui Chen) ； 王志生(Jyh-Seng Wang) ； 宗天一(Tien-Yi Tzung)

《中華皮膚科醫學雜誌》 24卷4期 (2006/12) Pp. 269-274

https://doi.org/10.29784/DS.200612.0007

摘要

撲類惡乃一由Streptomyces verticillus衍生出來的抗生素，並廣泛應用於抗癌、抗病毒、抗細菌、以及抗腫瘤的治療上。我們發表一個五十歲女性的病例，因肝硬化導致右側肋膜積水而接受以單一劑量撲類惡注射至肋膜內的肋膜沾黏術。在術後二十四小時內發生了全身性的搔癢。接著，條紋狀的色素沉著很快地出現於抓搔過的部位。由色素沉著處取下的皮膚切片顯示出黑色素在整個表皮層的增加，但黑色素細胞的數目並無增加。在給予局部類固醇治療後，搔癢與色素沉著逐漸消退。我們同時回顧了撲類惡導致之皮膚併發症的相關文獻，討論其多樣的臨床和病理表現及可能的致病機轉。

並列摘要

Bleomycin, derived from Streptomyces verticillus, is used extensively in anti-cancer, anti-viral, anti-bacterial, and anti-tumor therapy. We present herein a case of 50-year-old woman with right pleural effusion due to liver cirrhosis treated with a single intrapleural instillation of bleomycin for cavitary sclerosis. Generalized itching occurred within 24 hours. Subsequently, streak-like hyperpigmentation soon appeared in the post-scratched areas. A skin biopsy showed an obvious increase in the amount of melanin pigment throughout the epidermal layer without increased melanocytes. After topical application of corticosteroid, the pruritus and hyperpigmentation faded. We also review the literature and the various clinical and histopathological features associated with this cutaneous complication of bleomycin, discussing the possible pathogenic mechanisms.

並列關鍵字

Bleomycin ； Flagellate hyperpigmentation ； Hyperpigmentation ； Pleurodesis