Nineteen of 25 patients treated with systemic bleomycin therapy developed skin toxicities such as infiltrated plaques, nodules, and bands on the hands, linear hyperpigmentation on the trunk, and gangrene of the fingertips. The association of these changes with pulmonary fibrosis, which also occurs in patients treated with bleomycin, may suggest the possibility of a drug-induced scleroderma.
Cohen IS, Mosher MB, O'Keefe EJ, Klaus SN, De Conti RC. Cutaneous Toxicity of Bleomycin Therapy. Arch Dermatol. 1973;107(4):553-555. doi:10.1001/archderm.1973.01620190029007