Melanoma associated with long-term voriconazole therapy: A new manifestation of chronic photosensitivity

Daniel D. Miller, Edward W. Cowen, Josephine C. Nguyen, Timothy H. McCalmont, Lindy P. Fox

Research output: Contribution to journalArticlepeer-review

97 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)300-304
Number of pages5
JournalArchives of Dermatology
Volume146
Issue number3
DOIs
StatePublished - Mar 2010

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