By Disease Name > Necrobiotic Xanthogranuloma

Necrobiotic Xanthogranuloma

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an inflammatory histiocytoxanthomatosus involving the dermis and subcutaneous tissue
primarily affects the face; periorbital is the site of predilection (85%)
indurated yellow-red nodules, often ulcerated
frequently paraproteinemia (90%) IgG (kappa or lambda)
10% of patients develop myeloma

 

histology:

Touton giant cells with various amounts of necrobiosis or hyalin necrosis and the presence of lymphoid nodules
CD1a and S100 negative

 

ddx:

NLD facial and  scalp lesions are exceptional
subcutaneous GA mainly in children and does not ulcerate
Xanthoma Disseminata large body folds are the main sites of predilection and do not ulcerate
multicentric reticulohistiocytosis severe arthropathy and lesions do not tend to ulcerate (histology large histiocytes with “ground glass” cytoplasm and no necrobiosis)