Actinic keratosis is a common skin lesion that occurs in the elderly on sunlight exposed skin surfaces. These lesions are confined to the epidermis, but when they extend deeply into the dermis, they called squamous cell carcinoma. Numerous methods of AK treatment have been described depending on the extent of the disease. They can include cryotherapy, surgical removal, or topical drugs like imiquimod and 5-fluorouracil (5-FU). 5-FU is successful as a topical agent because it diffuses inside rapidly replicating cells and kills them with minimal effect on the normal cells. Toxic reaction and inflammation of the lesions is known to occur during the early stages of treatment. The inflammation can start within 1-2 weeks of beginning treatment and it can include different phases [1
]. Different systemic chemotherapy agents and combination protocols are also known to produce an inflammation of the actinic keratosis via unclear mechanism. Radiation recall reaction and susceptible cell with abnormal DNA have been suggested to explain AK inflammation [2
]. The most commonly described systemic chemotherapy agent that can cause a flair of actinic keratosis is 5-Fu [2
]. Other cited agents include dactinomycin-dacarbazine-vincristine combination, doxorubicin-cytarabine-thioguanine combination, sorafenib-tipifarnib combination, capecitabine, doxorubicin, erlotinib, deoxycoformycin, fludarabine, and cisplatin [2
]. Docetaxel, one of the taxane agents, has been described in one report to cause inflammation of actinic keratosis in two patients [7
]. No association between AK inflammation and the alkylating agent carboplatin has been found in the literature. To our knowledge, this is the first case report describing an association between actinic keratosis inflammation and the combination of carboplatin and docetaxel.
Our patient suffered from actinic keratosis inflammation after his second chemotherapeutic treatment for lung cancer using combination therapy. Certainly, it is known that docetaxel alone may induce this response. We cannot discern if the combination of these agents lead to a more robust flair than if he had received solely docetaxel. It should be investigated whether the sole use of carboplatin also has a similar effect on AK.