X-linked chronic granulomatous disease with voriconazole-induced photosensitivity/ photoaging reaction

Due to the mutations in the nicotinamide dinucleotide phosphate (NADPH) oxidase complex in X-linked chronic granulomatous disease (CGD), the phagocytic activity in these patients is curtailed by a dysfunctional respiratory burst. This can lead to life-threatening bacterial and fungal infections. The prognosis for patients with CGD has dramatically improved with the advent of effective prophylactic drugs targeting catalase-positive bacteria, opportunistic Gram-negative bacteria and fungi. Voriconazole, a second-generation triazole, is a commonly used agent for prophylaxis in this population. The authors report a case of photoaging and photosensitivity reaction associated with voriconazole exposure in a 10-year-old boy with X-linked CGD. With broad-spectrum sunscreen, topical steroids, and discontinuation of voriconazole, the patient showed significant improvement.