TABLE I.
Characteristics of patients with squamous cell carcinoma following chronic treatment with voriconazole.
| Patient | Age/sex | Ethnicity | Past medical history/duration of immunosuppression |
Voriconazole dose/duration |
History of immunosuppressant Use |
Other photosensitizing drugs |
Phototoxicity/ photodamage |
Neoplasia |
|---|---|---|---|---|---|---|---|---|
| 1 | 9/M | Caucasian | ALL/46 months s/p CBHCT |
150mg BID/39 mo.† | cyclosporine, daclizumab, prednisone,* thalidomide,* topical tacrolimus |
TMP/SMX | Erythema, cheilitis, lentigo formation on face, neck, dorsal forearms, hands |
AK/superficially invasive SCC SCC (2) |
| 2 | 11/M | Caucasian | ALL, ITP, 54 months s/p CBHCT |
50mg qd/54 mo. | azathioprine*, cyclosporine, daclizumab, sirolimus, prednisone*, thalidomide* |
none | Faint erythema, mild lentigo formation lateral neck, dorsal hands |
AK (2) SCCis (2) SCC (2) |
| 3 | 22/M | Caucasian | HIV (age 2) | 250mg bid/15 mo. | none | TMP/SMX | Extensive erythema and lentigo formation dorsal hands, head/neck, forearms, upper back |
SCC |
| 4 | 41/M | Caucasian | Non-Hodgkin's lymphoma/48 months s/p PBHCT |
250 mg bid/48 mo. | etanercept, methylprednisolone*, rituximab, tacrolimus* |
none | Faint erythema/extensive lentigo formation lateral, posterior neck |
SCC (4) |
| 5 | 46/M | Caucasian | Wegener's granulomatosis/122 months |
200mg bid/45 mo | prednisone, methotrexate |
none | Telangiectasias | SCC (10) |
| 6 | 43/M | Caucasian | ALL, 51 months s/p allo SCT |
200mg bid/51 mo | cyclosporine, prednisone, mycophenolate mofetil*, sirolimus* |
TMP/SMX | Erythema, telangiectasias, advanced photodamage |
SCC (25) |
| 7 | 28/M | Caucasian | CML, 84 months s/p allo SCT |
200mg bid/60 mo | tacrolimus*, mycophenolate mofetil, prednisone*, sirolimus* |
dapsone | Erythema, dermatoheliosis |
SCC (2), inflamed AKs |
| 8 | 54/M | Caucasian | CLL/SLL (small lymphocytic leukemia) 13 months s/p allo SCT |
350mg bid/13 mo | prednisone, tacrolimus |
None | Erythema, actinic keratoses |
SCC (2), AK (5) |
AK: actinic keratosis
ALL: acute lymphoblastic leukemia
CLL: chronic lymphocytic leukemia
CBSCT: cord blood stem cell transplant
ITP: idiopathic thrombocytopenic purpura
PBSCT: peripheral blood stem cell transplant
SCC: squamous cell carcinoma
SCCis: squamous cell carcinoma in situ
†
Drug discontinued 6 months prior to evaluation
*
Current immunosuppressant therapy at time of evaluation