Two Cases of Scleroderma-like Skin Sclerosis Induced by Chemotherapy Including Bleomycin

Abstract

We herein report two cases of bleomycin-induced scleroderma. Case 1 was a 60-year-old male, who developed edematous fingers on both hands 2 months after initiation of the BEP chemotherapy regimen (bleomycin, cisplatin, and etoposide) for testicular tumor. Edematous sclerosis spread to the forearms, and furthermore, nail pigmentation, acral pain and neuropathy appeared and worsened. Biopsy specimens taken from the finger and forearm revealed thickened collagen bundles in the dermis. Case 2 was a 48-year-old female, who had undergone surgery for vulvar cancer, which was followed by chemotherapy. After 7 courses of BEP therapy, the patient developed bilateral finger swelling and acral hyperpigmentation. Bleomycin-induced pulmonary fibrosis has been widely reported, whereas scleroderma-like skin sclerosis is rare. We discuss bleomycin-induced scleroderma with a review of previous works.