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necrobiotic xanthogranuloma
Etiology:
- paraproteinemia 99% (generally IgG kappa)
- multiple myeloma may develop [3]
Pathology:
1) cutaneous & subcutaneous xanthogranulomas
2) focal necrosis
3) giant cells
4) associated with paraproteinemia (99%)
- generally monoclonal gammopathy (IgG kappa)
* histopathology images [4,5]
Clinical manifestations:
1) multiple, large, sometimes ulcerated, red to yellow (purple to orange) granulomatous nodules & indurated plaques
2) atrophy & telangiectasias
3) may occur on trunk or periorbital areas, especially upper eyelids [3]
* images [4]
Laboratory:
1) serum protein electrophoresis shows
a) IgG kappa paraproteinemia, or
b) multiple myeloma
2) urine protein electrophoresis for Bence Jones protein
General
xanthogranuloma
References
- Stedman's Medical Dictionary 27th ed, Williams &
Wilkins, Baltimore, 1999
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 177-78
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18.
American College of Physicians, Philadelphia 2015, 2018.
- Wood AJ, Wagner MV, Abbott JJ, Gibson LE
Necrobiotic XanthogranulomaA Review of 17 Cases With
Emphasis on Clinical and Pathologic Correlation.
Arch Dermatol. 2009;145(3):279-284.
PMID: 19289757
http://archderm.jamanetwork.com/article.aspx?articleid=711962
- DermNet NZ. (histopathology images)
Necrobiotic xanthogranuloma pathology