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Arch Dermatol. 2010 Mar;146(3):300-4. doi: 10.1001/archdermatol.2009.362. Epub 2010 Jan 18.

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

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1
Department of Dermatology, University of California-San Francisco, 1701 Divisadero St., San Francisco, CA 94143, USA.

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.

Comment in

PMID:
20083676
DOI:
10.1001/archdermatol.2009.362
[Indexed for MEDLINE]

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