Acute generalized exanthematous pustulosis simulating Stevens-Johnson syndrome/toxic epidermal necrolysis associated with the use of vismodegib

Basal cell carcinoma (BCC) is a common skin neoplasm that usually has a nonaggressive behavior typically managed with local treatment (eg, surgery, photodynamic treatment, topical agents, or radiation). In some cases, BCC has a much more invasive behavior (locally advanced or metastatic BCC), which may require systemic treatment.1 An abnormal activation of the hedgehog pathway signaling has been linked to the pathogenesis of BCC. Vismodegib is the first-in-class inhibitor of this pathway.1,2 Patients with inoperable or unresectable disease are candidates for this treatment.