History: A 19 year-old black female with a history of an immature teratoma was admitted to Barnes-Jewish hospital for chemotherapy with bleomycin, cisplatan, and etoposide. A week into treatment, she developed brown streaks on her upper back, chest & hands (Fig 1, 2, and 3). These areas were pruritic.
The patient had linear and flagellate hyperpigmentation on the upper back and hyperpigmentation of the dorsal hands .
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