10.5826/dpc.1204a131
text/xml
2160-9381
2039
en
Iris Zalaudek
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Necrobiotic Xanthogranuloma as Sign of Monoclonal Gammopathy
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-10-31
2021-09-14
2022-10-31
2022-11-29
e2022131
Dermatol Pract Concept
Iris Zalaudek
2022/10/31
10.5826/dpc.1204a131
e2022131
Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy.
2160-9381
en
e2022131
Spicknall KE, Mehregan DA. Necrobiotic xanthogranuloma. Int J Dermatol. 2009 Jan;48(1):1-10. doi: 10.1111/j.1365-4632.2009.03912.x. PMID: 19126043
Necrobiotic Xanthogranuloma as Sign of Monoclonal Gammopathy
https://dpcj.org/index.php/dpc/article/download/2039/1798
                   Necrobiotic Xanthogranuloma as Sign
                       of Monoclonal Gammopathy
                                              Claudio Conforti1, Iris Zalaudek1


1 Dermatology Clinic, Maggiore Hospital, Piazza dell’Ospitale 1, University of Trieste, Trieste, Italy



Citation: Conforti C, Zalaudek I. Necrobiotic Xanthogranuloma as Sign of Monoclonal Gammopathy. Dermatol Pract Concept.
2022;12(4):e2022131. DOI: https://doi.org/10.5826/dpc.1204a131
Accepted: January 9, 2022; Published: October 2022
Copyright: ©2022 Conforti et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Claudio Conforti, MD, Dermatology Clinic, Hospital Maggiore, Trieste, Italy. Phone number: +39 3335441549,
E-mail address: claudioconforti@yahoo.com




Case presentation                                                          xanthogranuloma (NX) was suspected. A full laboratory
                                                                           workup was performed including skin and bone marrow
A 52-year-old woman referred to our skin cancer unit for                   ­biopsy, CT scan of the orbital region and urine ­examination.
the presence of yellow periorbital plaques that enlarged                   Tests revealed an IgG paraproteinemia without bone
over the past decade. Based on the clinical and dermoscopic                ­involvement and, based on skin biopsy, the diagnosis of NX
presentations (Figure 1), a clinical diagnosis of necrobiotic              BRAF wild type was confirmed.




 Figure 1. (A) Clinical appearance of necrobiotic xanthogranuloma showing eyelid and periorbital yellow plaques. (B) D
                                                                                                                     ­ ermoscopic f­ eatures
 of XN showing yellow structureless areas that correspond to the presence of histiocytes in the dermis. (C) H&E histological detail showing
 foamy histiocytes in the dermis.



Image Letter | Dermatol Pract Concept. 2022;12(4):e2022131                                                                                 1
Teaching Point                                                 References
Necrobiotic xanthogranuloma is a rare manifestation of         1. Spicknall KE, Mehregan DA. Necrobiotic xanthogranuloma.
                                                                  Int J Dermatol. 2009;48(1):1-10. DOI: 10.1111/j.1365-4632.
non-Langerhans histiocytosis and it is often associated with
                                                                  2009.03912.x. PMID: 19126043
monoclonal gammopathy.




2                                                                   Image Letter | Dermatol Pract Concept. 2022;12(4):e2022131
