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Necrobiotic xanthogranuloma associated with necrotizing scleritis.
Am J Dermatopathol 2012; 34(6):644-7AJ

Abstract

A 57-year-old man presented to the ophthalmology clinic with a red right eye. He denied pain, diplopia, tearing, and blurred vision. His medical history included asymptomatic annular plaques on the trunk and extremities for at least a decade. Ophthalmological examination revealed a necrotizing scleritis of the right eye. Examination of the skin demonstrated variable sized annular plaques with central atrophy, some with prominent indurated border and yellow discoloration. No periorbital lesions were present. The ocular lesion rapidly progressed and areas of scleral melting developed in the right eye, which eventually required a scleral patch graft. The left eye also developed necrotizing scleritis with areas of scleral melting. Two sets of skin biopsies were performed a few weeks apart. An initial set of skin punch biopsies revealed extensive palisading granulomatous inflammation throughout the dermis, extending into the subcutis. The accompanying perivascular mononuclear infiltrate contained the collections of plasma cells. Scattered multinucleated giant cells were noted. The possibility of necrobiosis lipoidica diabeticorum was suggested. Subsequent skin biopsies showed more prominent and extensive necrobiosis, raising the possibility of necrobiotic xanthogranuloma. Protein electrophoresis was performed, which revealed an IgG λ monoclonal protein.

Authors+Show Affiliations

Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22814320

Citation

Peyman, Amir, et al. "Necrobiotic Xanthogranuloma Associated With Necrotizing Scleritis." The American Journal of Dermatopathology, vol. 34, no. 6, 2012, pp. 644-7.
Peyman A, Walsh N, Green P, et al. Necrobiotic xanthogranuloma associated with necrotizing scleritis. Am J Dermatopathol. 2012;34(6):644-7.
Peyman, A., Walsh, N., Green, P., Dorey, M. W., Seamone, C., & Pasternak, S. (2012). Necrobiotic xanthogranuloma associated with necrotizing scleritis. The American Journal of Dermatopathology, 34(6), pp. 644-7. doi:10.1097/DAD.0b013e318234e73c.
Peyman A, et al. Necrobiotic Xanthogranuloma Associated With Necrotizing Scleritis. Am J Dermatopathol. 2012;34(6):644-7. PubMed PMID: 22814320.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Necrobiotic xanthogranuloma associated with necrotizing scleritis. AU - Peyman,Amir, AU - Walsh,Noreen, AU - Green,Peter, AU - Dorey,Michael W, AU - Seamone,Christopher, AU - Pasternak,Sylvia, PY - 2012/7/21/entrez PY - 2012/7/21/pubmed PY - 2013/3/30/medline SP - 644 EP - 7 JF - The American Journal of dermatopathology JO - Am J Dermatopathol VL - 34 IS - 6 N2 - A 57-year-old man presented to the ophthalmology clinic with a red right eye. He denied pain, diplopia, tearing, and blurred vision. His medical history included asymptomatic annular plaques on the trunk and extremities for at least a decade. Ophthalmological examination revealed a necrotizing scleritis of the right eye. Examination of the skin demonstrated variable sized annular plaques with central atrophy, some with prominent indurated border and yellow discoloration. No periorbital lesions were present. The ocular lesion rapidly progressed and areas of scleral melting developed in the right eye, which eventually required a scleral patch graft. The left eye also developed necrotizing scleritis with areas of scleral melting. Two sets of skin biopsies were performed a few weeks apart. An initial set of skin punch biopsies revealed extensive palisading granulomatous inflammation throughout the dermis, extending into the subcutis. The accompanying perivascular mononuclear infiltrate contained the collections of plasma cells. Scattered multinucleated giant cells were noted. The possibility of necrobiosis lipoidica diabeticorum was suggested. Subsequent skin biopsies showed more prominent and extensive necrobiosis, raising the possibility of necrobiotic xanthogranuloma. Protein electrophoresis was performed, which revealed an IgG λ monoclonal protein. SN - 1533-0311 UR - https://www.unboundmedicine.com/medline/citation/22814320/Necrobiotic_xanthogranuloma_associated_with_necrotizing_scleritis_ L2 - http://dx.doi.org/10.1097/DAD.0b013e318234e73c DB - PRIME DP - Unbound Medicine ER -