Bullous Phototoxicity from Voriconazole

Barbosa, Naiara S.; Wetter, David A.

doi:10.1016/j.jemermed.2013.09.018

Cited by 12 publications

(5 citation statements)

References 2 publications

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“…Exposure to cyanide can lead to significant toxic reactions, including cardiac dysfunction, neuronal necrosis, metabolic disorders and death [3]. 5α-carp cholesterol sulfate has been shown to be the main toxic component of bile of common carp [4], which is a kind of kidney and liver toxic substances. Liver biopsy after carp toxin administrated in mice showed liver necrosis and neutrophil infiltration.…”

Section: Discussionmentioning

confidence: 99%

A Case of Application of Bedside Continuous Renal Replacement Therapy on Treatment of MODS Caused by Fish Bile Poisoning

Zou¹,

Liu²,

Yu³

et al. 2017

JPT

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One case of 54 years old female patient was admitted to hospital due to vomiting and diarrhea for 3 days and abnormal renal function for 1 day. The patient appeared repeatedly vomiting and watery stools 6 hours after eating 2 grain of raw carp fish bile and gradually appeared oliguresis, whole body skin yellow dye and fever symptoms. The condition of patient had no improvement after visiting the emergency department of local county hospital. She was checked in department of nephropathy in our hospital for further diagnosis and treatment. Because the patient's condition was serious and the function of liver and kidney was damaged, diagnosed as severe multiple organ dysfunction syndrome (MODS), she was transferred to ICU rescue to protect the liver, maintain water and electrolyte balance, control blood sugar, improve the circulation and give other drug treatments and actively carry out bedside continuous renal replacement therapy. Then the body temperature and hemogram of the patients became normal, liver and kidney function improved obviously, urinary production became normal, skin yellow dye faded and vital signs became stable. The successful treatment of this patient indicated that bedside continuous renal replacement therapy can not only have a good support for the kidneys but also reduce the waterfall effect of inflammatory of patients with severe MODS, which has great therapeutic effect on the multi organ dysfunction caused by fish bile poisoning.

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Section: Discussionmentioning

confidence: 99%

A Case of Application of Bedside Continuous Renal Replacement Therapy on Treatment of MODS Caused by Fish Bile Poisoning

Zou¹,

Liu²,

Yu³

et al. 2017

JPT

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“…The triazoles shown to cause photosensitivity are itraconazole and voriconazole. Itraconazole induces an erythematous plaque with papules and vesicles on sun-exposed areas [ 174 ]. Voriconazole use is connected with phototoxic reactions.…”

Section: Characteristics Of Drugs With Photosensitive Potentialmentioning

confidence: 99%

“…Voriconazole use is connected with phototoxic reactions. Bullous photodermatosis [ 174 , 175 ] and photodistributed erythema have been reported during voriconazole treatment [ 176 ]. Moreover, chronic voriconazole therapy is associated with accelerated photoaging [ 177 ] and photocarcinogenesis-melanoma [ 178 ], and squamous cell carcinoma development [ 179 , 180 , 181 ].…”

Section: Characteristics Of Drugs With Photosensitive Potentialmentioning

confidence: 99%

Drug-Induced Photosensitivity—From Light and Chemistry to Biological Reactions and Clinical Symptoms

et al. 2021

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Photosensitivity is one of the most common cutaneous adverse drug reactions. There are two types of drug-induced photosensitivity: photoallergy and phototoxicity. Currently, the number of photosensitization cases is constantly increasing due to excessive exposure to sunlight, the aesthetic value of a tan, and the increasing number of photosensitizing substances in food, dietary supplements, and pharmaceutical and cosmetic products. The risk of photosensitivity reactions relates to several hundred externally and systemically administered drugs, including nonsteroidal anti-inflammatory, cardiovascular, psychotropic, antimicrobial, antihyperlipidemic, and antineoplastic drugs. Photosensitivity reactions often lead to hospitalization, additional treatment, medical management, decrease in patient’s comfort, and the limitations of drug usage. Mechanisms of drug-induced photosensitivity are complex and are observed at a cellular, molecular, and biochemical level. Photoexcitation and photoconversion of drugs trigger multidirectional biological reactions, including oxidative stress, inflammation, and changes in melanin synthesis. These effects contribute to the appearance of the following symptoms: erythema, swelling, blisters, exudation, peeling, burning, itching, and hyperpigmentation of the skin. This article reviews in detail the chemical and biological basis of drug-induced photosensitivity. The following factors are considered: the chemical properties, the influence of individual ranges of sunlight, the presence of melanin biopolymers, and the defense mechanisms of particular types of tested cells.

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“…It has sometimes been attributed to voriconazole [25][26][27][28] ; in one case it was controlled with a sunscreen during continued voriconazole exposure. 29 However, phototoxic reactions due to voriconazole can also be associated with true porphyria cutanea tarda, with superficial cheilitis.…”

Section: Mechanisms and Susceptibility Factorsmentioning

confidence: 99%

Photosensitivity reactions and skin tumours associated with voriconazole

Aronson¹

2015

Adverse Drug Reaction Bulletin

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Use of voriconazole, a triazole antifungal drug, has often been associated with photosensitivity, and this adverse reaction has been linked to a risk of tumours in light-exposed areas, especially squamous cell carcinomas, but also melanomas. The mechanisms by which voriconazole causes these effects are not clear, but susceptibility factors for a predisposition to skin cancers include duration of use, immunosuppression, ultraviolet (UV) exposure, advanced age, and skin type. Voriconazole should be used carefully, particularly in patients with susceptibility factors for skin cancer. If prolonged voriconazole therapy is required, it is advisable to have frequent diligent skin examinations, to avoid excess sunlight, and to use UV protectants liberally.

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Bullous Phototoxicity from Voriconazole

Cited by 12 publications

References 2 publications

A Case of Application of Bedside Continuous Renal Replacement Therapy on Treatment of MODS Caused by Fish Bile Poisoning

A Case of Application of Bedside Continuous Renal Replacement Therapy on Treatment of MODS Caused by Fish Bile Poisoning

Drug-Induced Photosensitivity—From Light and Chemistry to Biological Reactions and Clinical Symptoms

Photosensitivity reactions and skin tumours associated with voriconazole

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