A 57-year-old man was diagnosed as having a gastric adenocarcinoma, and underwent chemotherapy with 5-fluorouracil and cisplatin. Docetaxel was added as a second-line therapy 4 months later, because of metastases detected in the lung and liver. At the end of the first cycle of docetaxel, the patient developed asymptomatic, violaceous, infiltrated, partially scaling lesions on the dorsal surface of both hands (Fig. 1a) followed by the occurrence of multiple annular, erythematous plaques on his trunk (Fig. 1b). Skin biopsies were taken from lesions on the trunk and on the left hand, and histological examination identified interface dermatitis in both (Fig. 2a,b). Laboratory investigations revealed mild anaemia together with neutropenia and lymphopenia. Thrombocytopenia was absent. Erythrocyte sedimentation rate was 93 mm/h (normal range 0–20 mm/h), while C-reactive protein, rheumatoid factor and complement factors were normal. Serological analysis was positive for Ro/SS-A [7.4 (antibody index; normal range <1 AI)] La/ SS-B (3.8 AI) and antinuclear (1 : 320) antibodies. Direct immunofluorescence (DIF) of the biopsy from the hand lesion revealed granular deposits of IgG, IgM and C3 at the dermoepidermal junction (Fig. 2c). In agreement with the oncologist, docetaxel was discontinued and replaced by capecitabine. The cutaneous lesions improved in the following weeks but, to obtain complete remission, hydroxychloroquine (200 mg/day) was added. After 3 weeks, the skin lesions had resolved and there was no recurrence in the subsequent 9-month follow-up period (Fig. 1c,d). Given the clinical and histopathological data, the trunk lesions were diagnosed as subacute cutaneous lupus erythematosus (SCLE) induced by docetaxel. This was based on the temporal link between drug exposure and onset of skin lesions, which resolved after drug discontinuation. Serological results were consistent with a drug-induced SCLE (DI-SCLE). Moreover, docetaxel has been recently suggested to induce SCLE in immunogenetically predisposed patients by stabilizing microtubules and affecting Ro/SS-A antigen (Ro52) expression. By contrast, the diagnosis of the hand lesions is more questionable. Their appearance resembled dermatomyositis, especially with regard to the localization and the violaceous colour, but no papules or Gottron sign were seen, and no joint or muscle involvement was found. Both electromyography and serology tests were negative. Moreover, the trunk lesions were not consistent with dermatomyositis. Another possible differential diagnosis could be palmoplantar erythrodysaesthesia (PPE) syndrome, which has been reported as a common side effect of docetaxel. However, we excluded PPE because the hand lesions did not involve the palms or affect the feet, and were asymptomatic. Moreover, although the histopathological examination was compatible with PPE, DIF in PPE is usually negative, whereas in our case we found several immunological deposits. Therefore, our final diagnosis for the hand lesions was of an atypical manifestation of SCLE induced by docetaxel, based on (i) the histopathological examina-

In the present study, we reported two cases of renal cell carcinoma (RCC) diagnosed in pregnant women (Pt) that were submitted to radical nephrectomy, in both cases within the fourth month. The patients, after 13 and 3 years, respectively, did not show evidence of recurrent disease. We performed an immunohistochemical study on RCC specimens in comparison to seven age-matched controls (Cl). The panel of antibodies included Ki-67, p53, bcl-2, ER, PgR, PCNA, and IGF-1. We describe a difference in the expression of p53 and Ki-67. Specifically, p53 was highly expressed in RCC of both Pt but scarcely present or absent in Cl; by contrast, Ki-67 was hardly expressed or negative in RCC of both Pt, being commonly positive in Cl. These results may correlate with a good outcome of the disease in Pt. Although the limited number of cases did not permit any statistical evaluation, we postulate that these differences have not to be underestimated since they may disclose a correlation between pregnancy and biological behavior of tumoral disease. Further study may (dis)prove this hypothesis.