LAUSR

We report the case of a 63-year-old woman with a diagnosis of breast cancer who presented with an acute generalized exanthematous pustulosis (AGEP) after treatment with docetaxel and then developed a relapse during letrozole treatment. The clinical presentation and cutaneous biopsy findings led to the diagnosis of AGEP. Thus, chemotherapy was stopped, and the patient received appropriate local care and treatment with topical corticosteroids (betamethasone and desonide), which resulted in rapid regression of the skin lesions. After surgery and radiotherapy, anti-aromatase hormonal therapy (letrozole 2.5 mg/d) was started. However, 15 days later (6 months after the last docetaxel cycle), AGEP was again diagnosed. Letrozole was stopped immediately, and treatment with topical corticosteroids (desonide) was given, resulting in complete regression of the lesions within 1 week. This was an unprecedented case in which AGEP was induced by both docetaxel and letrozole in the same patient. Physicians should be vigilant when an atypical cutaneous reaction occurs during taxane chemotherapy or with aromatase inhibitor treatment because the skin lesions can become rather severe within only few days.