title: Severe skin toxicity in pediatric oncology patients treated with voriconazole and concomitant methotrexate.
abstract: We report the occurrence of skin toxicities in pediatric oncology patients on concomitant treatment with voriconazole and methotrexate (MTX). Of 23 patients who received this combination, 11 patients suffered from cheilitis and/or photosensitivity. In contrast, only in 1 of 9 patients who received voriconazole without MTX was photosensitivity observed. A mechanism of action was not able to be identified. We describe two cases with severe skin toxicities. Caution is warranted when using voriconazole and concomitant MTX.
authors.affiliation: Department of Clinical Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Johan G C
authors.initials: JG
authors.lastname: van Hasselt
authors.forename: Natasha K A
authors.initials: NK
authors.lastname: van Eijkelenburg
authors.forename: Alwin D R
authors.initials: AD
authors.lastname: Huitema
authors.forename: Jan H M
authors.initials: JH
authors.lastname: Schellens
authors.forename: Antoinette Y N
authors.initials: AY
authors.lastname: Schouten-van Meeteren
mesh_terms: D000293:Adolescent; D019072:Antibiotic Prophylaxis; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001228:Aspergillosis / Q000517:prevention & control; D002613:Cheilitis / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D017454:Dermatitis, Photoallergic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007947:Leukemia, Megakaryoblastic, Acute / Q000188:drug therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012867:Skin / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D000964:Antimetabolites, Antineoplastic; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole; D008727:Methotrexate