Discoid Lupus Erythematosus-Like Skin Changes in Patients With Autosomal Recessive Chronic Granulomatous Disease

To the Editor.—  Lupus erythematosus (LE)-like skin lesions have been reported regularly in carriers of X-linked chronic granulomatous disease (CGD).¹ However, discoid LE lesions have been described in only three cases of autosomal recessive CGD.^2,3 We describe the immunophenotyping of these lesions in two more patients.

Report of Cases.—Case 1.—  An 18-year-old boy with autosomal recessive, cytochrome-b-₅₅₈positive CGD, with absence of cytosolic 47 kd phosphoprotein, presented with skin lesions on his face, back, and chest that consisted of well-defined erythematous scaling plaques with slight atrophy, telangiectasias, hypopigmentation, and hyperpigmentation (Figure).

Case 2.—  A 26-year-old man with autosomal recessive cytochrome-b-₅₅₈positive CGD without the cytosolic 47 kd protein, had a dermatologic history of recurrent facial lesions during the last 6 years. Reasonably well-defined erythematous patches of various sizes with only slight scaling appeared on the face, and two welldefined lesions, reddish and scaling with