Flagellate erythema

What is the flagellate? erythema?

Flagellate erythema is a rare pattern eruption, what happens in linear stripes and generally follows chemotherapy. Also called flagellate pigmentation during its brown recovery phase.

What causes flagellate erythema?

Erythema flagellate was first described in association with bleomycin treatment. It has an onset between one day and several months after administration. Subsequently, it has also been associated with peplomycin (a derivative of bleomycin), docetaxel (another chemotherapy agent), dermatomyositis, adult-onset Still's disease, and Shiitake mushroom. dermatitis.

The exact cause of this eruption is uncertain, but several theories have been postulated. One theory is that trauma (to scratch) causes vasodilation with local accumulation of bleomycin in the skin causing a subsequent fixed drug eruption.

What are the signs and symptoms?

Flagellate erythema typically presents with an itch, coinciding with the appearance of linear red streaks, most commonly found on the back and flanks. Over time, the itching and redness resolve to leave brown pigmentation. The pattern in dermatomyositis is more inflammatory with persistent erythema.

Flagellate erythema

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Flagellate erythema

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Flagellate erythema

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Flagellate erythema

How was the diagnosis made?

The diagnosis of flagellate erythema is usually made by observing the typical pattern of the rash, particularly when following chemotherapy administration.

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In some cases a skin biopsy Can be done. the histology It has been reported that it shows hyperkeratosis, focal parakeratosisirregular acanthosis and spongiosis within epidermis. Dermal edema and perivascular lymphocytes are seen, and a band of basal epidermal melanin pigment It is characteristic.

What treatments are available?

In most cases, the rash resolves on its own. Take the symptom Itching is the main treatment measure. Systemic Steroids like prednisone or dexamethasone appear to delay the onset of the rash and can also help speed up its resolution. Heat in an area previously affected by flagellate erythema has caused reappearance, called heat-induced recall. Therefore, cooling before chemotherapy can prevent it. In the past, a mixture of glycerin and chlorhexidine was reported to be used with success.