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Generalized necrobiotic xanthogranuloma successfully treated with lenalidomide.
Sirunya Silapunt1, Susan Y Chon
1Department of Dermatology, University of Texas Medical School at Houston, Houston, TX, USA.
Journal of Drugs in Dermatology : JDD
|March 18, 2010
Summary
Necrobiotic xanthogranuloma (NXG) is difficult to treat. Lenalidomide effectively treated generalized NXG in a patient with monoclonal gammopathy of unknown significance (MGUS), resolving both conditions.
Area of Science:
- Dermatology
- Hematology
- Oncology
Background:
- Necrobiotic xanthogranuloma (NXG) is a rare, challenging granulomatous disease.
- Generalized NXG has limited therapeutic options.
- Monoclonal gammopathy of unknown significance (MGUS) is a plasma cell disorder preceding multiple myeloma.
Observation:
- A patient with generalized NXG and MGUS was observed.
- The patient had a plasma cell dyscrasia.
- NXG is associated with paraproteinemia.
Findings:
- Lenalidomide, a thalidomide derivative used for multiple myeloma, was administered.
- Treatment with lenalidomide led to the resolution of paraproteinemia.
- Resolution of paraproteinemia correlated with the resolution of NXG.
Implications:
- Lenalidomide shows promise for treating generalized NXG, especially when associated with MGUS.
- Targeting the underlying plasma cell dyscrasia may resolve refractory NXG.
- This suggests a potential therapeutic pathway for NXG linked to plasma cell disorders.
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