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Ophthalmological considerations in necrobiotic xanthogranuloma

and nail, suggesting that it may induce local proliferation of melanocytes. Although the precise mechanism of flagellate erythema is still unknown, there are several hypotheses of the mode of action of bleomycin. Firstly, the hyperpigmentation may be postinflammatory. Secondly, the causative agents may reduce epidermal turnover time and may prolong the contact between melanocytes and keratinocytes, or slow down the turnover of the keratinocytes, with blockade of melanocytes in the pigment synthesis. Thirdly, accumulation of the causative agents in the skin may cause fixed drug eruption as a result of their direct effects on keratinocytes. The inducement of flagellate erythema may not be specific to bleomycin, and further studies will be necessary to elucidate the underlying mechanisms of the condition.