Reactions 1704, p368 - 2 Jun 2018 Phototoxicity, invasive squamous cell carcinoma and periostitis: case report A-14-year old boy developed phototoxicity, invasive squamous cell carcinomas (SCCs) and periostitis during treatment with voriconazole for lung Aspergillus fumigatus infection. The boy, who had autosomal dominant hyper-IgE syndrome (HIES), started receiving treatment with voriconazole 400mg daily [route not stated] for the treatment of lung Aspergillus fumigatus infection. Three years after initiation of voriconazole, he developed phototoxicity in the form of multiple actinic keratoses and lentigines. Ten months later, he developed invasive SCCs at three different sites and SCC in situ at another site. The boy’s all SCCs were treated by surgical excision. One month after the surgery, he developed severe bilateral lower limb pain. The MRI confirmed periosteal reaction, which was consistent with voriconazole related periostitis. Therefore, voriconazole treatment was switched to posaconazole. Subsequently, phototoxicity decreased. Six weeks later, his musculoskeletal pain had completely resolved. Author comment: "However, voriconazole . . . can alternatively cause skin phototoxicity and SCC." "MRI demonstrated periosteal reaction consistent with periostitis secondary to voriconazole." "Withdrawal of voriconazole, as seen in our patient, can result in decreased phototoxicity and complete resolution of periostitis symptoms." Kim M, et al. Voriconazole-induced phototoxicity, malignancy and periostitis in a child with autosomal dominant hyper IgE syndrome. Australasian Journal of Dermatology 59 (Suppl. 1): 78, May 2018. Available from: URL: http:// doi.org/10.1111/ajd.17_12815 [abstract] - Australia 803323382 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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