Drug reactions: voriconazole photosensitivity: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Drug reactions: voriconazole photosensitivity

Sample item

A lung transplant recipient on long-term voriconazole develops severe sunburn-like reactions and, over the years, multiple scaly keratotic lesions on the face and hands, one of which proves to be a squamous cell carcinoma. Which advice is most important?

ASwitch to a tetracycline for protectionBStrict photoprotection and regular skin surveillance, with review of the drugCPrescribe oral isotretinoin in all casesDStop all sunscreen to allow tanning

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Strict photoprotection and regular skin surveillance, with review of the drug

Long-term voriconazole causes phototoxicity and is associated with an increased risk of squamous cell carcinoma, particularly in immunosuppressed transplant recipients. Management is rigorous sun protection, regular dermatological surveillance and, where possible, an alternative antifungal. Chemoprevention with acitretin may be considered in selected patients.

Option by option

A. Switch to a tetracycline for protection
Tetracyclines are themselves phototoxic and offer no protection.
B. Strict photoprotection and regular skin surveillance, with review of the drug (correct)
Correct. Photoprotection and surveillance, with review of the drug, are key.
C. Prescribe oral isotretinoin in all cases
Isotretinoin is not the standard approach, and acitretin is the retinoid used for chemoprevention.
D. Stop all sunscreen to allow tanning
Sun exposure worsens the risk of skin cancer in this patient.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is B, Strict photoprotection and regular skin surveillance, with review of the drug. Long-term voriconazole causes phototoxicity and is associated with an increased risk of squamous cell carcinoma, particularly in immunosuppressed transplant recipients.

Why is "Switch to a tetracycline for protection" not the answer?

Tetracyclines are themselves phototoxic and offer no protection.

Why is "Prescribe oral isotretinoin in all cases" not the answer?

Isotretinoin is not the standard approach, and acitretin is the retinoid used for chemoprevention.

Why is "Stop all sunscreen to allow tanning" not the answer?

Sun exposure worsens the risk of skin cancer in this patient.

What concept does this question test?

It tests Drug reactions: voriconazole photosensitivity in Dermatology. Management is rigorous sun protection, regular dermatological surveillance and, where possible, an alternative antifungal. Chemoprevention with acitretin may be considered in selected patients.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Drug reactions: voriconazole photosensitivity?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.