Voriconazole-associated phototoxic dermatoses and skin cancer.
Voriconazole's antifungal spectrum, oral bioavailability, and proven efficacy in treatment of invasive mycoses have led to its widespread off-label use for antifungal prophylaxis. There is an increasing recognition that long-term voriconazole use is associated with accelerated sun-induced skin changes that include acute phototoxicity reactions, photoaging, actinic keratosis and esp. among immunocompromised patients, skin cancers. The mechanisms underlying these dermatologic adverse events are not clearly understood. Population-risks of long-term voriconazole use need to be prospectively investigated. This review aims to provide an in-depth assessment of published literature and highlight salient findings from retrospective studies and case series. A broad practical guideline for assessment and management of these patients is provided.
a Division of Blood and Marrow Transplantation and Cellular Therapies, Department of Pediatrics , Children's Hospital of Pittsburgh of UPMC , Pittsburgh , PA , USA.|b University of Pittsburgh , Pittsburgh , PA , USA.
Rakesh K
RK
Goyal
D000818:Animals; D000935:Antifungal Agents / Q000009:adverse effects*; D017484:Dermatitis, Phototoxic / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D012878:Skin Neoplasms / Q000139:chemically induced* / Q000175:diagnosis* / Q000453:epidemiology; D065819:Voriconazole / Q000009:adverse effects*
D000935:Antifungal Agents; D065819:Voriconazole
Chronic granulomatous disease; hematopoietic cell transplantation; immunocompromised host; phototoxicity; skin phototypes; solid organ transplantation; squamous cell carcinoma; sun protection; ultraviolet radiation; voriconazole