Necrobiotic xanthogranuloma

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


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



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



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



See also


  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.