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Ten boys and two girls, aged 2-15 years*, were identified from a retrospective chart review after they developed cheilitis and/or photosensitivity while receiving voriconazole. Eleven patients were also receiving methotrexate, with intrathecal administration in two cases; a pharmacodynamic interaction was thought to have occurred.
The patients, who had acute lymphoblastic leukaemia (ALL), were all receiving antifungal prophylaxis with oral voriconazole 150-200mg twice daily. Eleven patients were also receiving methotrexate at either high-dose (3000-5000 mg/m2) or low-dose (20-30 mg/m2/week) as part of their ALL therapy; two patients were receiving intrathecal low-dose methotrexate [remaining routes and some frequencies...