By Gary M. White, MD
Voriconazole is an oral antifungal agent that has been reported to have various dermatologic effects, the most notable being the predisposition to melanoma and squamous cell carcinoma formation. These effects include:
- Predisposition to squamous cell carcinoma, melanoma, and melanoma in situ
- UV-A photosensitivity (blistering, pruritus, cheilosis, eczema and lentigo formation)
- Multiple atypical lentigines.
Voriconazole is FDA approved for children older than 2 years of age. Approximately 20% of children on voriconazole develop photo toxicity [JAAD 2015;72;314]. White race and high cumulative dose are risk factors. In one study from UCSF, voriconazole increased the risk of SCC by 73% in lung transplant patients. [Dermatology News, May 2015 p. 10].
Patients of any age should be counseled on photo protection and receive routine surveillance for skin cancer.
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