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Correspondence |

Voriconazole-Associated Phototoxic Effects and Lentigo Formation in an African American Man

David J. Elbaum, MD; Edward W. Cowen, MD, MHSc
Arch Dermatol. 2012;148(8):965-966. doi:10.1001/archdermatol.2012.705.
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Correspondence: Dr Cowen, Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Dr, MSC 1908 Bldg 10, Room 12N238, Bethesda, MD 20814 (cowene@mail.nih.gov).

Financial Disclosure: None reported.

Clancy CJ, Nguyen MH.Long-term voriconazole and skin cancer: is there cause for concern? Curr Infect Dis Rep. 2011;13(6):536-543
PubMed   |  Link to Article[[XSLOpenURL/10.1007/s11908-011-0220-x]]
Cowen EW, Nguyen JC, Miller DD,  et al. Chronic phototoxicity and aggressive squamous cell carcinoma of the skin in children and adults during treatment with voriconazole. J Am Acad Dermatol. 2010;62(1):31-37
PubMed   |  Link to Article[[XSLOpenURL/10.1016/j.jaad.2009.09.033]]
Miller DD, Cowen EW, Nguyen JC, McCalmont TH, Fox LP.Melanoma associated with long-term voriconazole therapy: a new manifestation of chronic photosensitivity. Arch Dermatol. 2010;146(3):300-304
PubMed   |  Link to Article[[XSLOpenURL/10.1001/archdermatol.2009.362]]
Vadnerkar A, Nguyen MH, Mitsani D,  et al. Voriconazole exposure and geographic location are independent risk factors for squamous cell carcinoma of the skin among lung transplant recipients. J Heart Lung Transplant. 2010;29(11):1240-1244
PubMed   |  Link to Article[[XSLOpenURL/10.1016/j.healun.2010.05.022]]
Murayama N, Imai N, Nakane T, Shimizu M, Yamazaki H.Roles of CYP3A4 and CYP2C19 in methyl hydroxylated and N-oxidized metabolite formation from voriconazole, a new anti-fungal agent, in human liver microsomes. Biochem Pharmacol. 2007;73(12):2020-2026
PubMed   |  Link to Article[[XSLOpenURL/10.1016/j.bcp.2007.03.012]]
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Figure 1. Clinical images. A, Prominent erythema on the cheeks and distal aspect of the nose; note also the large erosion on the sun-exposed mucosal aspect of the lower lip. B, Erythema and numerous irregularly shaped lentigos are present in a photodistributed pattern on the forearm. C, Close-up image of lentigo lesions.

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Figure 2. Hematoxylin-eosin–stained skin biopsy specimens from the forearm. A, Lichenoid dermatitis without basement membrane thickening or dermal mucin (original magnification ×20). B, Lentigo (original magnification ×8).

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