BACKGROUND: Voriconazole is a triazole antifungal agent approved by the US Food and Drug Administration for serious fungal infections, including with Aspergillus, Fusarium, Pseudallescheria, and Scedosporium species. In initial clinical trials, approximately 2% of patients developed cutaneous reactions, including photosensitivity, cheilitis, and xerosis. Subsequent reports have implicated voriconazole as a cause of severe photosensitivity and accelerated photoaging, pseudoporphyria cutanea tarda, and aggressive squamous cell carcinoma. OBSERVATION: We report 5 melanoma in situ lesions in the setting of extreme photosensitivity associated with long-term voriconazole therapy. CONCLUSIONS: We recommend surveillance for skin cancer formation in all patients who require long-term voriconazole treatment, particularly those who manifest signs or symptoms of photosensitivity or chronic photodamage. Further study of the mechanism underlying voriconazole photosensitivity and oncogenesis is warranted.
BACKGROUND:Voriconazole is a triazole antifungal agent approved by the US Food and Drug Administration for serious fungal infections, including with Aspergillus, Fusarium, Pseudallescheria, and Scedosporium species. In initial clinical trials, approximately 2% of patients developed cutaneous reactions, including photosensitivity, cheilitis, and xerosis. Subsequent reports have implicated voriconazole as a cause of severe photosensitivity and accelerated photoaging, pseudoporphyria cutanea tarda, and aggressive squamous cell carcinoma. OBSERVATION: We report 5 melanoma in situ lesions in the setting of extreme photosensitivity associated with long-term voriconazole therapy. CONCLUSIONS: We recommend surveillance for skin cancer formation in all patients who require long-term voriconazole treatment, particularly those who manifest signs or symptoms of photosensitivity or chronic photodamage. Further study of the mechanism underlying voriconazole photosensitivity and oncogenesis is warranted.
Authors: George R Thompson; Derek Bays; Stuart H Cohen; Demosthenes Pappagianis Journal: Antimicrob Agents Chemother Date: 2011-10-17 Impact factor: 5.191
Authors: Elizabeth M Kang; Betty E Marciano; SukSee DeRavin; Kol A Zarember; Steven M Holland; Harry L Malech Journal: J Allergy Clin Immunol Date: 2011-04-17 Impact factor: 10.793
Authors: Mamina M Turegano; Chyi-Chia R Lee; Harry L Malech; Suk S De Ravin; Edward W Cowen; Isaac Brownell Journal: J Am Acad Dermatol Date: 2014-03 Impact factor: 11.527