Skin Cancer Checks Needed for Patients on Voriconazole

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

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.

Daniel D. Miller, 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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Jane Parry

Jane Parry

Published on January 20, 2010

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