Difference between revisions of "Necrobiotic xanthogranuloma"

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#redirect [[Inflammatory_skin_disorders#Necrobiotic_xanthogranuloma]]
'''Necrobiotic xanthogranuloma''', abbreviated '''NXG''', is a rare [[granuloma|granulomatous]] [[skin]] condition that is typically periorbital.
 
==General==
*Usually elderly.<ref name=Ref_Derm629>{{Ref Derm|629}}</ref>
*Associated with monoclonal gammopathy.<ref>{{Cite journal  | last1 = Mehregan | first1 = DA. | last2 = Winkelmann | first2 = RK. | title = Necrobiotic xanthogranuloma. | journal = Arch Dermatol | volume = 128 | issue = 1 | pages = 94-100 | month = Jan | year = 1992 | doi =  | PMID = 1739294 }}</ref>
**There is case report of NXG without a monoclonal gammopathy.<ref name=pmid25566570>{{Cite journal  | last1 = Seastrom | first1 = S. | last2 = Bookout | first2 = A. | last3 = Hogan | first3 = DJ. | title = Necrobiotic xanthogranuloma without a monoclonal gammopathy. | journal = Cutis | volume = 94 | issue = 6 | pages = 293-6 | month = Dec | year = 2014 | doi =  | PMID = 25566570 }}</ref>
 
==Gross==
Features:
*Yellow plaques.
*Periorbital - classic location.<ref name=pmid17544963>{{Cite journal  | last1 = Fernández-Herrera | first1 = J. | last2 = Pedraz | first2 = J. | title = Necrobiotic xanthogranuloma. | journal = Semin Cutan Med Surg | volume = 26 | issue = 2 | pages = 108-13 | month = Jun | year = 2007 | doi = 10.1016/j.sder.2007.02.008 | PMID = 17544963 }}</ref>
**66% of cases periorbital in one series.<ref name=pmid27238425>{{Cite journal  | last1 = Higgins | first1 = LS. | last2 = Go | first2 = RS. | last3 = Dingli | first3 = D. | last4 = Kumar | first4 = SK. | last5 = Rajkumar | first5 = SV. | last6 = Dispenzieri | first6 = A. | last7 = Buadi | first7 = FK. | last8 = Lacy | first8 = MQ. | last9 = Lust | first9 = JA. | title = Clinical Features and Treatment Outcomes of Patients With Necrobiotic Xanthogranuloma Associated With Monoclonal Gammopathies. | journal = Clin Lymphoma Myeloma Leuk | volume =  | issue =  | pages =  | month = May | year = 2016 | doi = 10.1016/j.clml.2016.04.009 | PMID = 27238425 }}</ref>
 
==Microscopic==
Features:<ref name=Ref_Derm629>{{Ref Derm|629}}</ref>
*"Necrobiotic granuloma":
**Palisading granuloma with a core collagen-like material.
*+/-Cholesterol clefts - common.
*+/-[[Touton giant cell]]s.
*+/-Atypical foreign body-type giant cells +/- asteroid bodies.
 
DDx:
*[[Granuloma annulare]].
*[[Necrobiosis lipoidica]] - has plasma cells.
*Granuloma-forming infections - positive stains for microorganisms.
*[[Juvenile xanthogranuloma]].
 
===Image===
*[http://commons.wikimedia.org/wiki/File:Asteroid_bodies_high_mag_cropped.jpg Asteroid body (WC)].
 
==See also==
*[[Inflammatory skin disorders]].
*[[Giant cells]].
 
==References==
{{Reflist|1}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]

Latest revision as of 20:19, 17 June 2016

Necrobiotic xanthogranuloma, abbreviated NXG, is a rare granulomatous skin condition that is typically periorbital.

General

  • Usually elderly.[1]
  • Associated with monoclonal gammopathy.[2]
    • There is case report of NXG without a monoclonal gammopathy.[3]

Gross

Features:

  • Yellow plaques.
  • Periorbital - classic location.[4]
    • 66% of cases periorbital in one series.[5]

Microscopic

Features:[1]

  • "Necrobiotic granuloma":
    • Palisading granuloma with a core collagen-like material.
  • +/-Cholesterol clefts - common.
  • +/-Touton giant cells.
  • +/-Atypical foreign body-type giant cells +/- asteroid bodies.

DDx:

Image

See also

References

  1. ↑ 1.0 1.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 629. ISBN 978-0443066542.
  2. ↑ Mehregan, DA.; Winkelmann, RK. (Jan 1992). "Necrobiotic xanthogranuloma.". Arch Dermatol 128 (1): 94-100. PMID 1739294.
  3. ↑ Seastrom, S.; Bookout, A.; Hogan, DJ. (Dec 2014). "Necrobiotic xanthogranuloma without a monoclonal gammopathy.". Cutis 94 (6): 293-6. PMID 25566570.
  4. ↑ Fernández-Herrera, J.; Pedraz, J. (Jun 2007). "Necrobiotic xanthogranuloma.". Semin Cutan Med Surg 26 (2): 108-13. doi:10.1016/j.sder.2007.02.008. PMID 17544963.
  5. ↑ Higgins, LS.; Go, RS.; Dingli, D.; Kumar, SK.; Rajkumar, SV.; Dispenzieri, A.; Buadi, FK.; Lacy, MQ. et al. (May 2016). "Clinical Features and Treatment Outcomes of Patients With Necrobiotic Xanthogranuloma Associated With Monoclonal Gammopathies.". Clin Lymphoma Myeloma Leuk. doi:10.1016/j.clml.2016.04.009. PMID 27238425.
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