A 58-year-old man developed acute myeloid leukemia. After responding to remission-induction high-dose chemotherapy, he received an allogeneic stem cell transplant that was complicated by a graft-versus-host reaction. While being treated for the latter with prednisone(Drug information on prednisone), tacrolimus(Drug information on tacrolimus) (Prograf), and mycophenolate mofetil (CellCept), he developed both fungal pneumonia and osteomyelitis caused by Fusarium species. Following successful initial liposomal amphotericin-B therapy, he was placed on long-term antifungal prophylaxis. Although he had a history of neither actinic keratoses nor nonmelanoma skin cancer, he developed the rapidly growing scalp tumor depicted. The neoplasm ultimately proved to be a poorly differentiated squamous cell carcinoma.
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