Rapid development of keratoacanthoma and accelerated transformation into squamous cell carcinoma of the skin: a mutagenic effect of polychemotherapy in a patient with Hodgkin's disease?

A 59-year-old white man developed keratoacanthoma of the nose immediately following one course of MOPP polychemotherapy for clinical state IV B mixed cellularity Hodgkin's disease. Despite the dramatic response of Hodgkin's disease to intensive chemotherapy, the skin lesion was rapidly transformed into squamous cell carcinoma in 10 weeks. The immunosuppressive effect of intensive polychemotherapy may play a significant role in accelerating the malignant transformation. We report here our results concerning this complication which may occur in any patient with Hodgkin's disease undergoing intensive therapy.