What causes flagellate erythema?
Flagellate erythema was first described in association with bleomycin treatment. It has an onset anywhere between one day and several months after administration. Subsequently it has also been associated with peplomycin (a bleomycin derivative), docetaxel (another chemotherapy agent), dermatomyositis, adult-onset Still’s disease and Shiitake mushroom dermatitis. The exact cause of this rash is uncertain, but a number of theories have been postulated. One theory is that trauma (scratching) causes vasodilation with local bleomycin accumulation in the skin causing a subsequent fixed drug eruption.
