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Necrobiotic xanthogranuloma treated with chlorambucil
Sima Z Torabian1, Nasim Fazel, Robin Knuttle
1University of California Davis, Department of Dermatology, USA. sima.torabian@ucdmc.ucdavis.edu
Dermatology Online Journal
|September 12, 2006
Summary
Necrobiotic xanthogranuloma, a rare condition, can be effectively treated with chlorambucil. This case study shows complete resolution of skin lesions in a patient receiving this chemotherapy agent.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Necrobiotic xanthogranuloma (NXG) is a rare, chronic granulomatous disease.
- NXG often presents with characteristic skin lesions and may be associated with systemic conditions, including monoclonal gammopathies.
Observation:
- A 56-year-old male presented with a 5-year history of pruritic, ulcerated, and atrophic plaques on the periorbital area, extremities, and trunk.
- Laboratory findings revealed mild leukopenia and IgG lambda monoclonal gammopathy.
- Histopathology demonstrated a dense histiocytic infiltrate with hyaline necrobiosis, multinucleated giant cells, and lymphocytes.
Findings:
- The patient was diagnosed with necrobiotic xanthogranuloma.
- Treatment initiated with chlorambucil at 2 mg/day, subsequently increased to 4 mg/day.
- Complete resolution of skin lesions was observed following chlorambucil treatment.
Implications:
- Chlorambucil demonstrates efficacy in managing necrobiotic xanthogranuloma.
- This case highlights the importance of considering systemic treatments for refractory or extensive NXG.
- Further research may explore chlorambucil's role in larger cohorts of NXG patients.
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