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Chronic phototoxicity and aggressive squamous cell carcinoma of the skin in children and adults during treatment with voriconazole Cowen EW; Nguyen JC; Miller DD; McShane D; Arron ST; Prose NS; Turner ML; Fox LPJ Am Acad Dermatol 2010[Jan]; 62 (1): 31-37BACKGROUND: 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.|Adolescent[MESH]|Adult[MESH]|Antifungal Agents/administration & dosage/*adverse effects[MESH]|Carcinoma, Squamous Cell/*chemically induced/epidemiology/secondary[MESH]|Child[MESH]|Comorbidity[MESH]|DNA Damage/radiation effects[MESH]|Dermatitis, Phototoxic/epidemiology/*etiology/genetics[MESH]|Fatal Outcome[MESH]|Female[MESH]|Hematopoietic Stem Cell Transplantation[MESH]|Humans[MESH]|Immunocompromised Host[MESH]|Middle Aged[MESH]|Pyrimidines/administration & dosage/*adverse effects[MESH]|Retrospective Studies[MESH]|Skin Neoplasms/*chemically induced/epidemiology/pathology[MESH]|Triazoles/administration & dosage/*adverse effects[MESH]|Voriconazole[MESH]|Young Adult[MESH] |
