Chronic phototoxicity and aggressive squamous cell carcinoma of the skin in children and adults during treatment with voriconazole.

Published

Journal Article

BACKGROUND: Voriconazole is a broad-spectrum antifungal agent associated with photosensitivity and accelerated photoaging. A possible link with aggressive squamous cell carcinoma (SCC) has also been reported. OBJECTIVE: We sought to determine the incidence and frequency of cutaneous SCC among patients undergoing long-term treatment with voriconazole who also manifest features of chronic phototoxicity. METHODS: We conducted a retrospective review of patients who developed one or more squamous cell neoplasms during long-term treatment with voriconazole at 3 academic dermatology centers. RESULTS: A total of 51 cutaneous SCC were identified in 8 patients (median age 34.5 years, range 9-54) treated with chronic voriconazole (median duration 46.5 months, range 13-60). Underlying diagnoses included graft-versus-host disease, HIV, and Wegener granulomatosis. Signs of chronic phototoxicity and accelerated photoaging included erythema, actinic keratoses, and lentigo formation. LIMITATIONS: The retrospective nature of the study cannot determine the true population risk of SCC associated with voriconazole therapy. A prospective cohort study is needed. CONCLUSION: A high index of suspicion for photosensitivity and SCC may be warranted with chronic voriconazole use when used in the setting of concurrent immunosuppression.

Full Text

Duke Authors

Cited Authors

  • Cowen, EW; Nguyen, JC; Miller, DD; McShane, D; Arron, ST; Prose, NS; Turner, ML; Fox, LP

Published Date

  • January 2010

Published In

Volume / Issue

  • 62 / 1

Start / End Page

  • 31 - 37

PubMed ID

  • 19896749

Pubmed Central ID

  • 19896749

Electronic International Standard Serial Number (EISSN)

  • 1097-6787

Digital Object Identifier (DOI)

  • 10.1016/j.jaad.2009.09.033

Language

  • eng

Conference Location

  • United States