Squamous cell carcinoma voriconazole

Squamous cell carcinoma occurred after prolonged use of voriconazole in an HIV-infected patient [58 ] and a 69-year-old renal transplant patient [59 ]. 

In a case-control study in 543 lung transplant recipients, 17 (3.1%) developed squamous cell carcinomas Mer a median follow-up of 36 months [62 ]. The median time to development was 19 months after transplantation. Risk factors by univariate analysis included older age, residence in locations with high levels of sun exposure, single-lung transplantation, and duration and cumulative dose of voriconazole. The duration of voriconazole therapy and residence in locations with high sun exposure were independent risk factors by multivariate analysis. The lesions were located on the head and neck in 94% of cases and 53% had multiple lesions. After surgery at least one further independent lesion developed in 47% of patients. There was local spread and distant metastases in 7% of cases. There were no deaths. 

Four immunocompromised patients developed multiple squamous cell carcinomas while taking voriconazole for 2-3 years, preceded by photosensitization lesions and predominately found in photoexposed area, particularly the face [erf... 

A 55-year-old man with pulmonary aspergillosis developed a phototoxic reaction after taking voriconazole for a few months, followed by multiple squamous cell carcinomas on sun-exposed skin areas [65 ]. After voriconazole withdrawal, no new carcinomas were observed. Exploration of gene mutations involved in skin carcinogenesis showed two variants of the MICR gene. 

Brunei AS, Fraisse T, Lechiche C, Pinzani V, Mauboussin JM, Sotto A. Multifocal squamous cell carcinomas in an HIV-infected patient with a long-term voriconazole therapy. AIDS 2008 22(7) 905-6. 

Vanacker A, Fabr6 G, Van Dorpe J, Peetermans WE, Maes B. Aggressive cutaneous squamous cell carcinoma associated with prolonged voriconazole therapy in a renal transplant patient. Am J Transplant 2008 8(4) 877-80. 

McCarthy KL, Playford EG, Looke DF, Whitby M. Severe photosensitivity causing multifocal squamous cell carcinomas secondary to prolonged voriconazole therapy. CUn Infect Dis 2007 44(5) e55-6. 

Cowen EW, Nguyen JC, Miller DD, McShane D, Arron ST, Prose NS, Turner ML, Fox LP. 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) 31-7. 

Epaulard O, Saint-Raymond C, Villier C, Charles J, Roch N, Beani JC, Leccia MT. Multiple aggressive squamous cell carcinomas associated with prolonged voriconazole therapy in four immunocompromised patients. Clin Microbiol Infect 2010 16(9) 1362-4. 

Ibrahim SF, Singer JP, Arron ST. Catastrophic squamous cell carcinoma in lung transplant patients treated with voriconazole. Dermatol Surg 2010 36(11) 1752-5. 

Morice C, Acher A, Soufir N, Michel M, Comoz F, Leroy D, Verneuil L. Multifocal aggressive squamous cell carcinomas induced by prolonged voriconazole therapy a case report. Case Rep Med 2010 2010 351084. 

Tumorigenicity Squamous cell carcinoma has been associated with voriconazole in four patients who had taken it for 2-3 years [77 ]. The lesions were preceded by lesions photosensitization, and were predominantly in photoexposed areas, particularly the face. Replacement by posaconazole or itraconazole did not trigger other photosensitive lesions. Once voriconazole was withdrawn, preneoplastic lesions regressed. 

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