Inflammation of actinic keratoses after the use of docetaxel plus cyclophosphamide

Abstract

Actinic keratoses are common pre-malignant lesions of the skin that have been documented to become inflamed after the use of chemotherapy. Several agents, such as 5-fluorouracil, capecitabine, pentostatin, dactinomycin, vincristine, dacarbazine, cytarabine, 6-thioguanine, sorafenib, paclitaxel, and docetaxel have been documented to cause this reaction. This case report aims to describe the inflammation of actinic keratoses in response to docetaxel plus cyclophosphamide. A 64-year-old woman undergoing chemotherapy for breast cancer presented to the clinic with multiple scaly, erythematous papules covering her shoulders, arms, chest, and back. This occurred 15 days after treatment with IV docetaxel plus cyclophosphamide. The results of the shave biopsies done at the visit were consistent with inflammation. She was treated with topical triamcinolone ointment and the inflammation greatly improved within one month. The inflammation was completely resolved two months after completing therapy with docetaxel plus cyclophosphamide. Documentation of cutaneous adverse events help provide awareness of this reaction and thereby prevent cessation of necessary cancer treatments. Further research is needed to determine which patients undergoing chemotherapy may be susceptible to inflammation of actinic keratoses.