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Duration of voriconazole exposure: an independent risk factor for skin cancer after lung transplantation.

Publication ,  Journal Article
Zwald, FO; Spratt, M; Lemos, BD; Veledar, E; Lawrence, C; Marshall Lyon, G; Chen, SC
Published in: Dermatol Surg
August 2012

OBJECTIVE: To determine whether there is an association between duration of voriconazole therapy and number of nonmelanoma skin cancers (NMSC) after lung transplantation. DESIGN: A telephone-based survey and chart review were performed for all living patients who received a lung transplant at Emory University from 1993 to 2009. SETTING: Academic medical center. PARTICIPANTS: Lung transplant recipients. MAIN OUTCOME MEASURED: Number of NMSC after lung transplantation. RESULTS: Sixty of 91 (65.9%) subjects were exposed to voriconazole for at least 3 months (11.2 ± 8.7 months, range 3-58 months) after lung transplantation, of whom 16 developed NMSC, with a mean of 38 months to first NMSC. Of 31 patients not exposed to voriconazole, 12 developed NMSC, with a mean of 52 months to first NMSC . By univariate analysis, time since transplant (correlation coefficient (r) = 0.514), age (r = 0.101), and high lifetime sun exposure (r = 0.211) were correlated with number of skin cancers after transplantation. Skin types V and VI were protective (r = -0.353). In multivariate regression, time since transplantation (0.061 per month), age (0.151 per year), skin type I or II (4.939), and months of exposure to voriconazole (0.149) were found to be independent risk factors for number of skin cancers after lung transplantation. CONCLUSION: Duration of voriconazole exposure correlates with number of NMSC after lung transplantation. All patients exposed to voriconazole should be educated about their increased risk of skin cancer and should have regular dermatologic follow-up for skin cancer screening. Physicians caring for lung-transplant recipients should consider alternatives to voriconazole in patients at risk for skin cancer.

Duke Scholars

Published In

Dermatol Surg

DOI

EISSN

1524-4725

Publication Date

August 2012

Volume

38

Issue

8

Start / End Page

1369 / 1374

Location

United States

Related Subject Headings

  • Voriconazole
  • Triazoles
  • Skin Neoplasms
  • Risk Factors
  • Pyrimidines
  • Mycoses
  • Middle Aged
  • Male
  • Lung Transplantation
  • Immunocompromised Host
 

Citation

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Zwald, F. O., Spratt, M., Lemos, B. D., Veledar, E., Lawrence, C., Marshall Lyon, G., & Chen, S. C. (2012). Duration of voriconazole exposure: an independent risk factor for skin cancer after lung transplantation. Dermatol Surg, 38(8), 1369–1374. https://doi.org/10.1111/j.1524-4725.2012.02418.x
Zwald, Fiona O., Margaret Spratt, Bianca D. Lemos, Emir Veledar, Clint Lawrence, George Marshall Lyon, and Suephy C. Chen. “Duration of voriconazole exposure: an independent risk factor for skin cancer after lung transplantation.Dermatol Surg 38, no. 8 (August 2012): 1369–74. https://doi.org/10.1111/j.1524-4725.2012.02418.x.
Zwald FO, Spratt M, Lemos BD, Veledar E, Lawrence C, Marshall Lyon G, et al. Duration of voriconazole exposure: an independent risk factor for skin cancer after lung transplantation. Dermatol Surg. 2012 Aug;38(8):1369–74.
Zwald, Fiona O., et al. “Duration of voriconazole exposure: an independent risk factor for skin cancer after lung transplantation.Dermatol Surg, vol. 38, no. 8, Aug. 2012, pp. 1369–74. Pubmed, doi:10.1111/j.1524-4725.2012.02418.x.
Zwald FO, Spratt M, Lemos BD, Veledar E, Lawrence C, Marshall Lyon G, Chen SC. Duration of voriconazole exposure: an independent risk factor for skin cancer after lung transplantation. Dermatol Surg. 2012 Aug;38(8):1369–1374.
Journal cover image

Published In

Dermatol Surg

DOI

EISSN

1524-4725

Publication Date

August 2012

Volume

38

Issue

8

Start / End Page

1369 / 1374

Location

United States

Related Subject Headings

  • Voriconazole
  • Triazoles
  • Skin Neoplasms
  • Risk Factors
  • Pyrimidines
  • Mycoses
  • Middle Aged
  • Male
  • Lung Transplantation
  • Immunocompromised Host