Bleomycin

Bleomycin 

  • Pregnancy Category D

Formulations 

  • Intralesional (IL): 0.1 mL of 1U/mL per lesion, (max 2 mL per session)

Dosage 

  • Repeat every 2-4 weeks as needed

  • Binds DNA during the M & G2 phases of the cell cycle inducing single strand breaks and decreasing protein synthesis
  • Has antiviral, antibacterial, antitumor properties

Off-label

  • Verruca vulgaris

  • 24-72 hours: erythema, swelling, pain followed by blackened thrombotic eschar
  • Raynaud’s, permanent loss of nail plate, nail dystrophy, flagellate hyperpigmentation

  • Avoid in Pregnancy, children, immunosuppression, possible vascular compromise

  • Should be stored at -22 degrees Celsius
  • Can be injected with needleless high velocity DermoJet 
  • Can do ice water soaks twice daily to decrease pain
  • Can be combined with pulsed dye laser (PDL then IL-bleomycin)