Necrobiotic xanthogranuloma with immunoglobulin G kappa paraproteinemia and eve involvement / 中华皮肤科杂志

ABSTRACT

A 74-year-old man presented with yellowish red nodules and plaques on the trunk for more than one year.Physical examination showed more than 20 scattered,irregularly shaped,well-demarcated,yellowish red nodules and plaques measuring 0.5-15 cm in diameter on the trunk.The plaques on the right lower abdomen showed central ulceration and atrophy with scar formation.Plasma protein electrophoresis revealed that the levels of immunoglobulin G (IgG) and kappa light chain were 18.3 g/L and 20.70 g/L respectively.Histopathologically,large necrobiotic areas and granuloma were observed alternately in the dermis and subcutis.There were numerous Touton giant cells,foreign body giant cells and foamy histiocytes in the granuloma,and many cholesterol clefts were found in the center of necrobiotic areas with the formation of lymphoid follicles in some regions.Both eyes of the patient were involved to different degrees.He was diagnosed as necrobiotic xanthogranuloma with IgG kappa paraproteinemia and eve involvement.