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Necrobiotic xanthogranuloma without a monoclonal gammopathy.

Abstract

Necrobiotic xanthogranuloma (NXG) is an indolent non-Langerhans cell histiocytosis characterized by yellow xanthomatous plaques that tend to ulcerate. Necrobiotic xanthogranulomas have a predilection for the bilateral periorbital region and often present with consequential ophthalmic findings. Histopathology usually reveals a distinctive pattern of histiocytic xanthogranuloma with hyaline necrobiosis. Necrobiotic xanthogranuloma has been documented to have a close association with paraproteinemia. We report the case of a 76-year-old man with periorbital NXG without development of a monoclonal gammopathy. Clinically, the patient presented with dry eyes and substantial periorbital edema with multiple yellow indurated plaques. He developed the condition 30 years prior to presentation at which time it was initially diagnosed as xanthelasma. He underwent surgical excision of the lesions 10 years prior to the current presentation and biopsy results revealed a diagnosis of NXG. The periorbital lesions recurred several years prior to presentation, prompting annual computed tomography scans to rule out ocular invasion. Periorbital edema and plaques improved during a 6-month regimen of acitretin but returned to baseline just months after discontinuation.

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  • Authors+Show Affiliations

    , ,

    Nova Southeastern University College of Osteopathic Medicine, Largo Medical Center, 201 14th St, Largo, FL 33770, USA. angela.bookout@gmail.com.

    Source

    Cutis 94:6 2014 Dec pg 293-6

    MeSH

    Acitretin
    Aged
    Biopsy
    Dermatologic Surgical Procedures
    Dry Eye Syndromes
    Face
    Humans
    Keratolytic Agents
    Male
    Necrobiotic Xanthogranuloma
    Postoperative Complications
    Recurrence
    Skin
    Treatment Outcome

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    25566570

    Citation

    * When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Necrobiotic xanthogranuloma without a monoclonal gammopathy. AU - Seastrom,Stacey, AU - Bookout,Angela, AU - Hogan,Daniel J, PY - 2015/1/8/entrez PY - 2015/1/8/pubmed PY - 2015/9/1/medline SP - 293 EP - 6 JF - Cutis JO - Cutis VL - 94 IS - 6 N2 - Necrobiotic xanthogranuloma (NXG) is an indolent non-Langerhans cell histiocytosis characterized by yellow xanthomatous plaques that tend to ulcerate. Necrobiotic xanthogranulomas have a predilection for the bilateral periorbital region and often present with consequential ophthalmic findings. Histopathology usually reveals a distinctive pattern of histiocytic xanthogranuloma with hyaline necrobiosis. Necrobiotic xanthogranuloma has been documented to have a close association with paraproteinemia. We report the case of a 76-year-old man with periorbital NXG without development of a monoclonal gammopathy. Clinically, the patient presented with dry eyes and substantial periorbital edema with multiple yellow indurated plaques. He developed the condition 30 years prior to presentation at which time it was initially diagnosed as xanthelasma. He underwent surgical excision of the lesions 10 years prior to the current presentation and biopsy results revealed a diagnosis of NXG. The periorbital lesions recurred several years prior to presentation, prompting annual computed tomography scans to rule out ocular invasion. Periorbital edema and plaques improved during a 6-month regimen of acitretin but returned to baseline just months after discontinuation. SN - 0011-4162 UR - https://www.unboundmedicine.com/medline/citation/25566570/Necrobiotic_xanthogranuloma_without_a_monoclonal_gammopathy_ L2 - http://www.cutis.com/the-publication/past-issues-single-view/necrobiotic-xanthogranuloma-without-a-monoclonal-gammopathy/7bb22ef8326a1b68868cdd4b6211bc76.html DB - PRIME DP - Unbound Medicine ER -