Skin Cancer Checks Needed for Patients on Voriconazole

January 21, 2010

Long-term users with photosensitivity or chronic photodamage may be at risk

Publish date: Jan 20, 2010

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WEDNESDAY, Jan. 20 (HealthDay News) -- Patients receiving long-term treatment

for fungal infections who show signs of photosensitivity or chronic photodamage

should be monitored for skin cancer formation, according to an article published

online Jan. 18 in the Archives of Dermatology.

D. , M.D., of the University of California in San Francisco, and

colleagues report on five melanoma in situ lesions found on two patients -- a

39-year-old woman with coccidioidomycosis meningitis who took voriconazole for

three years and had two diagnoses of melanoma in situ; and a 21-year-old man who

developed lentigines in sun-exposed areas after two years of voriconazole

treatment for pulmonary Aspergillus infection and developed melanoma in situ

after 55 months of treatment.

The researchers found similarities in the clinical findings for both patients,

notably the rapid onset of extensive lentigines, and the short time frame

between starting voriconazole therapy and developing melanoma. The clinical

symptoms were similar to that of patients treated with psoralen plus UV-A

photochemotherapy, but the process of carcinogenesis was even more accelerated,

the investigators discovered.

" Ideally, surveillance for photosensitivity and cutaneous malignant neoplasms

should be prospectively included in future clinical trial design for the drug, "

the authors write. " Until such studies further define the skin cancer risk

associated with voriconazole, we recommend surveillance for skin cancer

formation in all patients who require long-term voriconazole treatment. "

One author reported a financial relationship with Cutera Lasers.

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