Pembrolizumab-induced resolving papulosquamous eruption: An enigmatic presentation in a patient with renal cell carcinoma

I want to thank the authors for their interest in my article.^[1] In their “letter to the editor,” they have mainly stressed on the cutaneous manifestations and paraneoplastic conditions that may be found in renal cell carcinoma patients.^[2] They have not raised any obvious queries regarding my article, which clearly mentioned that the patient was diagnosed case of renal cell carcinoma and the papulosquamous eruption appeared after starting pembrolizumab and lenvatinib. Further, whenever, pembrolizumab was withdrawn, the lesions had a spontaneous resolution. Therefore, based on this finding, a cutaneous association with renal cell carcinoma itself is unlikely, and it was the drug that was causing the development of papulosquamous eruption. However, I completely agree with their conclusion that we must not forget “the great imitators,” and in individual cases, care should be taken to delineate a drug eruption from a paraneoplastic condition to optimize the management.