Toxicities associated with bleomycin

Bleomycin is an anti-neoplastic antibiotic used in chemotherapeutic regimens for Hodgkin lymphoma, testicular tumour and Kaposi’s sarcoma and to induce chemical pleurodesis in malignant effusions. Bleomycin toxicity predominantly affects the skin and lungs. Skin toxicity classically presents as flagellate erythema, a rare drug rash, where the patient appears to have been whipped. Bleomycininduced pneumonitis is more commonly recognised and can occasionally prove fatal. Although both these conditions are well documented in the literature, in clinical practice the are uncommon.