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Phototoxicity and photocarcinogenesis associated with voriconazole

O Epaulard1, M-T Leccia, S Blanche

  • 1Service des maladies infectieuses et de médecine tropicale, CHU de Grenoble, France. OEpaulard@chu-grenoble.fr

Medecine Et Maladies Infectieuses
|November 8, 2011
PubMed

Insights

Voriconazole, an antifungal, can cause skin issues like phototoxicity and squamous cell carcinomas, especially with long-term use. Strict sun protection is crucial, and alternative antifungals may be needed if skin reactions occur.

Area of Science:

  • Dermatology
  • Pharmacology
  • Oncology

Background:

  • Voriconazole is an antifungal medication approved in 2002.
  • Cutaneous adverse effects, primarily phototoxicity, are known side effects.
  • Long-term voriconazole use is linked to aggressive cutaneous squamous cell carcinomas.

Purpose of the Study:

  • To review phototoxicity and photocarcinogenesis associated with voriconazole.
  • To analyze case reports of photo-induced skin adverse events.
  • To discuss mechanisms and risk factors for voriconazole-related skin cancers.

Main Methods:

  • Literature review of published case reports.
  • Analysis of safety data from voriconazole effectiveness studies.
  • Synthesis of information on phototoxicity mechanisms and outcomes.

Main Results:

  • Phototoxic events affect approximately 8% of outpatients.
  • 61 case reports detail photo-induced skin events, including 18 cases of squamous cell carcinoma.
  • Potential mechanisms involve direct drug phototoxicity, metabolite interaction, and retinoid metabolism disruption.

Conclusions:

  • Voriconazole requires strict photoprotection due to phototoxicity risks.
  • Immunodeficiency may increase the risk of voriconazole-associated skin cancer.
  • Further research is needed on voriconazole's phototoxicity, photocarcinogenesis, and chronic skin lesion prognosis.

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