asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2022-003asurgery-350Research ArticleФЛЕБОЛОГИЯPHLEBOLOGYРазвитие хлыстовой гиперпигментации кожи после использования блеомицина для склеротерапии сосудистых мальформаций с медленными потоковыми характеристикамиThe development of flagellate hyperpigmentation after use of bleomycin for sclerotherapy slow flow vascular malformationshttps://orcid.org/0000-0001-9436-3352СафинД. А.SafinD. A.

Сафин Динар Адхамович, врач, детский хирург, 249035, Обнинск, проспект Ленина, д. 137, к. 2;

руководитель центра, 127486, Москва, Коровинское шоссе, д. 9, к. 2

Dinar A. Safin, Paediatric Surgeon,137, Bldg. 2, Lenin Ave., Obninsk, Kaluga Region, 249035;

Head of the Center, 9, Bldg. 2, Korovinskoe Shosse, Moscow, 127486

safindinar@ya.ruhttps://orcid.org/0000-0003-2995-7140АгибаловД. Ю.AgibalovD. Y.

Агибалов Дмитрий Юрьевич, врач-хирург, руководитель клиники, 

249035, Калужская обл., Обнинск, проспект Ленина, д. 137, к. 2

Dmitri Y. Agibalov, Surgeon, Head of the Clinic, 

137, Bldg. 2, Lenin Ave., Obninsk, Kaluga Region, 249035

agibalovd@bk.ruКлиника «Доктор плюс»; Первый центр «Гемангиома»РоссияMedical Clinic “Doctor Plus”; First Vascular Center “Hemangioma”Russian FederationКлиника «Доктор плюс»РоссияMedical Clinic “Doctor Plus”Russian Federation2023190520232016068Copyright © Сафин Д.А., Агибалов Д.Ю., 20232023Сафин Д.А., Агибалов Д.Ю.Safin D.A., Agibalov D.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/350Введение

Введение. Блеомицин является цитотоксическим антибиотиком, который применяется в качестве склерозирующего средства для склеротерапии сосудистых аномалий. При его использовании характерны осложнения: тошнота, рвота, лихорадка, развитие аллергии / анафилаксии, изменение цвета кожи (гиперпигментация), повреждение легочной ткани.

Цель

Цель. Изучить частоту развития гиперпигментации после введения блеомицина для склеротерапии сосудистых мальформаций с медленными потоковыми характеристиками. Представить собственное клиническое наблюдение развития гиперпигментации после склеротерапии венозной мальформации блеомицином.

Материалы и методы

Материалы и методы. Проведен систематический обзор в иностранных (PubMed, Web Of Science, Google Scholar, Scopus) и отечественных базах данных (eLibrary) за период с 2012 по 2022 г. В результате отбора осталось 17 полнотекстовых статей, подходящих для их включения в анализ.

Результаты

Результаты. В первой части обзора был проведен анализ 12 статей с описанием клинических наблюдений развития хлыстовой гиперпигментации после химиотерапии различных новообразований. Во второй части обзора проведен анализ 4 статей с описанием клинических наблюдений развития гиперпигментации после интралесионального введения блеомицина в сосудистое образование у 19 пациентов. Обсуждение. Возникновение специфической хлыстовой гиперпигментации после введения блеомицина для склеротерапии сосудистых аномалий с медленными потоковыми характеристиками является редким осложнением. В проведенном анализе нет четкой связи возникновения гиперпигментации с превышением дозировки.

Заключение

Заключение. Для профилактики появления гиперпигментации необходимо избегать избыточной травматизации во время и сразу после склеротерапии, в том числе электродами ЭКГ; во время оказания анестезиологического пособия избегать избыточной оксигенации; необходимо избегать избыточной инсоляции в течение 24–48 ч после склеротерапии. 

Introduction

Introduction. Bleomycin is a cytotoxic antibiotic that is used as a sclerosing agent for sclerotherapy of vascular anomalies. Bleomycin is characterized by complications: nausea, vomiting, fever, the development of allergies/anaphylaxis, skin discoloration (hyperpigmentation), damage to lung tissue.

Aim

Aim. To study the frequency of hyperpigmentation after administration of bleomycin for sclerotherapy of vascular malformations with slow flow characteristics. To present our own clinical observation of the development of skin hyperpigmentation after sclerotherapy of venous malformation with bleomycin.

Materials and methods

Materials and methods. A systematic review was conducted in foreign (PubMed, Web Of Science, Google Scholar, Scirus) and domestic databases (eLibrary) for the period from 2012 to 2022. As a result of the selection, 17 full-text articles remained suitable for their inclusion in the analysis.

Results

Results. In the first part of the review, 12 articles were analyzed, describing clinical observations of the development of “flaggelate” hyperpigmentation after chemotherapy of various neoplasms. In the second part of the review, an analysis of 4 articles describing clinical observations of the development of hyperpigmentation after intralesional administration of bleomycin into vascular malformation in 19 patients was carried out. Discussion. The occurrence of specific “flaggelate” hyperpigmentation after administration of bleomycin for sclerotherapy of vascular anomalies with slow flow characteristics is a rare complication. In the analysis carried out, there is no clear connection between the occurrence of hyperpigmentation and excess dosage.

Conclusion

Conclusion. To prevent the appearance of hyperpigmentation, it is necessary to avoid excessive traumatization on time and immediately after sclerotherapy, including with ECG electrodes; avoid excessive oxygenation during the provision of anesthesia; it is necessary to avoid excessive insolation within 24–48 hours after sclerotherapy. 

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The authors declare that there are no conflicts of interest present.