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.