Our patient was a 62-year-old white man diagnosed recently with a form of pancreatic carcinoma. Per his report, the cancer was judged inoperable, and he was instead placed on a multiagent chemotherapeutic regimen. He could not recall the names of the specific agents when he came to our clinic.
Two weeks after initiation of this regimen, he noticed acne upon his face, neck, and upper chest (Figure 1). Even his scalp was involved, and he also reported some "thinning of [his] hair" that was difficult to quantify (Figure 2). The lesions began as small erythematous papules, but many became frank pustules over time. There was some associated pruritus. He had a history of limited acne as a teenager, but he did not have a strong personal or family history of nodulocystic acne or rosacea. There was no involvement of his nails.
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