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Atypical Lentigines in a Man With Mixed African American and White Race/Ethnicity Receiving Long-term Voriconazole Therapy

Paul R. Massey, BA1; Karolyn A. Wanat, MD2; Rosalie Elenitsas, MD2; Misha Rosenbach, MD3
[+] Author Affiliations
1Perelman School of Medicine, Philadelphia, Pennsylvania
2Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia
3Department of Dermatology, University of Pennsylvania, Philadelphia
JAMA Dermatol. 2014;150(3):334-335. doi:10.1001/jamadermatol.2013.6128.
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Voriconazole, an antifungal agent frequently used in systemic fungal infections, has been implicated in phototoxicity and photoaging.1 Chronic voriconazole phototoxicity and accelerated photoaging may contribute to the development of melanoma and squamous cell carcinoma.1,2 We describe the development of multiple lentigines and atypical melanocytic lesions in a dark-skinned man receiving long-term voriconazole therapy.

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Figure 1.
Clinical Images

New onset growth of lentigines on the forearms of a man with mixed African American and white race/ethnicity (A) with an irregularly pigmented macule that was biopsied (B).

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Figure 2.
Histopathologic Analysis

A, Histopathologic analysis of the irregularly pigmented macule demonstrated single-cell growth of melanocytes along the dermal-epidermal junction among a lentiginous background (hematoxylin-eosin, original magnification ×200). B, MART-1 staining highlights the increased growth of predominantly single melanocytes (original magnification ×200).

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