Phototoxic dermatoses in pediatric BMT patients receiving voriconazole

We investigated the incidence of phototoxic skin reactions in pediatric BMT recipients treated with voriconazole. Nine out of 40 patients (22.5%), all Caucasian, developed skin lesions in sun‐exposed distributions. Dermatologic findings included sunburn‐like erythema, pseudo‐porphyria, linear papulovesicular lesions, severe erosive cheilitis, dermatoheliosis and lentigines. Patients were treated with sun avoidance, high‐potency sunscreens, and topical steroids with significant improvement in all cases. Prolonged voriconazole use requires close monitoring for chronic skin toxicities. Long‐term risks including the risk of skin cancer need to be investigated. Pediatr Blood Cancer 2014;61:1325–1328. © 2014 Wiley Periodicals, Inc.

[1]  P. Ravaud,et al.  A multistep voriconazole-related phototoxic pathway may lead to skin carcinoma: results from a French nationwide study. , 2013, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[2]  D. Denning,et al.  Voriconazole‐induced photosensitivity: photobiological assessment of a case series of 12 patients , 2013, The British journal of dermatology.

[3]  S. Doudounakis,et al.  Voriconazole pharmacokinetics and photosensitivity in children with cystic fibrosis. , 2012, Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society.

[4]  P. Ravaud,et al.  Phototoxicity and photocarcinogenesis associated with voriconazole. , 2011, Medecine et maladies infectieuses.

[5]  H. Jafri,et al.  Pharmacokinetics, Safety, and Tolerability of Voriconazole in Immunocompromised Children , 2010, Antimicrobial Agents and Chemotherapy.

[6]  S. Arron,et al.  Chronic phototoxicity and aggressive squamous cell carcinoma of the skin in children and adults during treatment with voriconazole. , 2010, Journal of the American Academy of Dermatology.

[7]  M. Turner,et al.  Voriconazole-induced phototoxicity masquerading as chronic graft-versus-host disease of the skin in allogeneic hematopoietic cell transplant recipients. , 2009, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[8]  G. Nahler.  summary of product characteristics (SPC, SmPC) , 2009 .

[9]  Thierry Buclin,et al.  Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  M. Shimizu,et al.  Roles of CYP3A4 and CYP2C19 in methyl hydroxylated and N-oxidized metabolite formation from voriconazole, a new anti-fungal agent, in human liver microsomes. , 2007, Biochemical pharmacology.

[11]  D. Denning,et al.  Muco‐cutaneous retinoid‐effects and facial erythema related to the novel triazole antifungal agent voriconazole , 2001, Clinical and experimental dermatology.

[12]  R. Stern,et al.  Severe adverse cutaneous reactions to drugs. , 1994, The New England journal of medicine.