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Flagellate pigmentation and sclerodermoid changes: Cutaneous markers of blemycin toxicity.

Bleomycin therapy causes multiple side effects. Linear or flagellate pigmentation of the skin is a pattern of pigmentation unique to bleomycin therapy. We report 3 cases of testicular tumors on bleomycin therapy, all of whom manifested with flagellate pigmentation on the neck, trunk and upper limbs and one of whom developed sclerodermoid changes on the arm. Bleomycin, though used in different drug combinations, has consistently resulted in the manifestation of flagellate streaks of pigmentation.