Recurrent erythematous plaques on sun-exposed sites in an African American boy with chronic granulomatous disease - 14/02/14

Doi : 10.1016/j.jaad.2013.09.051

Mamina M. Turegano, MD ^a, Chyi-Chia R. Lee, MD, PhD ^b, Harry L. Malech, MD ^c, Suk S. De Ravin, MD ^c, Edward W. Cowen, MD, MHSc ^d, Isaac Brownell, MD, PhD ^d,^⁎
^a Department of Dermatology, Medstar Washington Hospital Center and Georgetown University Hospital, Washington, District of Columbia
^b Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
^d Dermatology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
^c Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland

^∗Correspondence to: Isaac Brownell, MD, PhD, Dermatology Branch, Center for Cancer Research, National Cancer Institute, Bldg 10/Room 12N238, 10 Center Dr, Bethesda, MD 20892-1908.

Abstract

Key teaching points

•	We report a case of a 6-year-old African American boy with X-linked CGD who developed DLE–like skin lesions after starting voriconazole.
•	Voriconazole is commonly used to treat fungal infections in patients with CGD.
•	Lupus erythematosus–like skin lesions have been reported in carriers of X-linked CGD and, less commonly, in patients with CGD.
•	Voriconazole is a significant cause of drug-induced photosensitivity, and may play a role in unmasking an underlying predisposition to lupuslike skin lesions.
•	Photoprotective measures and routine examinations to monitor for skin toxicity, including skin cancer, are prudent during voriconazole treatment.

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Key words : chronic granulomatous disease, discoid lupus erythematosus, drug reaction, lupuslike eruption, photoeruption, phototoxicity, voriconazole

Abbreviations used : CGD, DLE, PAS-D, TMP-SMX, UV

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	Supported by the Intramural Program of National Institutes of Health (NIH), Center for Cancer Research, National Cancer Institute. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
	Conflicts of interest: None declared.
	Reprints not available from the authors.