Multiple periocular adult onset xanthogranulomas in a patient with chronic lymphocytic leukaemia

Adult and juvenile forms of cutaneous xanthogranuloma share many clinical and histopathological features. Unlike the juvenile variant, systemic disorders including haematological malignancies have only rarely been reported in association with adult xanthogranuloma. We report a case of multiple periocular xanthogranulomas arising in a 43 year old man with chronic lymphocytic leukaemia. This case supports the emerging hypothesis that both juvenile and adult xanthogranulomas may share an association with an underlying haematological malignancy. Also highlighted is the fact that some patients with periocular cutaneous xanthogranulomas of adult onset can have co-existing orbital xanthogranulomatous disease and appropriate clinical and radiological investigations may be needed for accurate diagnosis.