Document Detail


Chronic phototoxicity and aggressive squamous cell carcinoma of the skin in children and adults during treatment with voriconazole.
MedLine Citation:
PMID:  19896749     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Edward W Cowen; Josephine C Nguyen; Daniel D Miller; Diana McShane; Sarah T Arron; Neil S Prose; Maria L Turner; Lindy P Fox
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Publication Detail:
Type:  Case Reports; Journal Article; Multicenter Study; Research Support, N.I.H., Intramural     Date:  2009-11-06
Journal Detail:
Title:  Journal of the American Academy of Dermatology     Volume:  62     ISSN:  1097-6787     ISO Abbreviation:  J. Am. Acad. Dermatol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-19     Completed Date:  2010-02-18     Revised Date:  2012-03-08    
Medline Journal Info:
Nlm Unique ID:  7907132     Medline TA:  J Am Acad Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-7     Citation Subset:  IM    
Affiliation:
Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA. cowene@mail.nih.gov
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antifungal Agents / administration & dosage,  adverse effects*
Carcinoma, Squamous Cell / chemically induced*,  epidemiology,  secondary
Child
Comorbidity
DNA Damage / radiation effects
Dermatitis, Phototoxic / epidemiology,  etiology*,  genetics
Fatal Outcome
Female
Hematopoietic Stem Cell Transplantation
Humans
Immunocompromised Host
Middle Aged
Pyrimidines / administration & dosage,  adverse effects*
Retrospective Studies
Skin Neoplasms / chemically induced*,  epidemiology,  pathology
Triazoles / administration & dosage,  adverse effects*
Young Adult
Grant Support
ID/Acronym/Agency:
Z99 CA999999/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Pyrimidines; 0/Triazoles; 0/voriconazole
Comments/Corrections

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