All-trans-retinoic Acid–Induced Scrotal Ulcers in a Patient With Acute Promyelocytic Leukemia

Acute promyelocytic leukemia (APL) accounts for 10% of acute myelocytic leukemias and is charac­terized by t(15;17) that produces the PML-RARα (promyelocytic leukemia-retinoic acid receptor α) fusion oncoprotein. The discovery and implemen­tation of all-trans-retinoic acid (ATRA) therapy for APL has led to complete remission rates greater than 90% when coupled with chemotherapy. We report a novel case of ATRA-induced scrotal ulcers in a black man with APL. The differential diagnosis of scrotal ulcerations in immunocom­promised patients is lengthy, and misdiagnosis can lead to substantial morbidity and mortality. It is important for dermatologists to be aware of this potential complication of ATRA therapy.