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

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:62

Article

Cowen, Edward W.¹  Nguyen, Josephine C.¹  Miller, Daniel D.²  McShane, Diana³  Arron, Sarah T.²  Prose, Neil S.³  Turner, Maria L.¹  Fox, Lindy P.² 

[1] NCI, Dermatol Branch, Ctr Canc Res, NIH, Bethesda, MD 20892 USA

[2] Univ Calif San Francisco, Dept Dermatol, San Francisco, CA 94143 USA

[3] Duke Univ, Dept Dermatol, Durham, NC 27706 USA

关键词: fungal infection;    immunosuppression;    photoaging;    photosensitivity;    phototoxicity;    squamous cell carcinoma;    voriconazole;   

DOI  :  10.1016/j.jaad.2009.09.033

来源: Elsevier

【 摘 要 】

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. (J Am Acad Dermatol 2010;62:31-7.)

【 授权许可】

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