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Phototoxic dermatoses in pediatric BMT patients receiving voriconazole

Authors

  • Rakesh K. Goyal MD,

    Corresponding author
    1. Division of Blood and Marrow Transplantation and Cellular Therapies, Children's Hospital of Pittsburgh of UPMC, Pennsylvania
    2. Departments of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
    • Correspondence to: Rakesh K. Goyal, Division of Blood and Marrow Transplantation and Cellular Therapies, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Pittsburgh, PA.

      E-mail: goyark@chp.edu

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  • Robin P. Gehris MD,

    1. Pediatric Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Denise Howrie PharmD,

    1. Pharmacy at Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
    2. Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Kayla M. Cogley PA,

    1. Division of Blood and Marrow Transplantation and Cellular Therapies, Children's Hospital of Pittsburgh of UPMC, Pennsylvania
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  • Randy M. Windreich MD,

    1. Division of Blood and Marrow Transplantation and Cellular Therapies, Children's Hospital of Pittsburgh of UPMC, Pennsylvania
    2. Departments of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Raman Venkataramanan PhD

    1. Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Conflict of interest: Nothing to declare.

Abstract

We investigated the incidence of phototoxic skin reactions in pediatric BMT recipients treated with voriconazole. Nine out of 40 patients (22.5%), all Caucasian, developed skin lesions in sun-exposed distributions. Dermatologic findings included sunburn-like erythema, pseudo-porphyria, linear papulovesicular lesions, severe erosive cheilitis, dermatoheliosis and lentigines. Patients were treated with sun avoidance, high-potency sunscreens, and topical steroids with significant improvement in all cases. Prolonged voriconazole use requires close monitoring for chronic skin toxicities. Long-term risks including the risk of skin cancer need to be investigated. Pediatr Blood Cancer 2014;61:1325–1328. © 2014 Wiley Periodicals, Inc.

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