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Journal of the American Academy of Dermatology
Volume 3, n° 3
pages 257-270 (septembre 1980)
Doi : 10.1016/S0190-9622(80)80189-7
Clinical and laboratory studies

Necrobiotic xanthogranuloma with paraproteinemia
 

Steven Kossard, M.B., Ph.D. , R.K. Winkelmann, M.D., Ph.D.
 From the Department of Dermatology, Mayo Clinic and Mayo Foundation, USA 

1Reprint requests to: Dr. Steven Kossard, c/o Section of Publications, Mayo Clinic, 200 First St., SW, Rochester, MN 55901.
Abstract

Eight patients had multiple xanthomatous plaques and subcutaneous nodules that had a predilection for the periorbital area, flexures, and trunk and that tended to ulcerate. Skin biopsy specimens showed a combination of xanthogranulomatous nodules with necrobiosis. All patients had an accompanying dysproteinemia, which was a monoclonal IgG paraprotein in six. Hyperlipidemia, low serum complement, and cryoglobulinemia were variable features. Five patients had leukopenia. Bone marrow examination showed myeloma in two patients, a lymphoproliferative process in one, and some atypical plasma cells in two. Cutaneous necrobiotic xanthogranuloma is a distinctive histologic pattern most frequently related to plasma cell dyscrasias, and it should be distinguished from normolipemic plane xanthoma and other necrobiotic granulomas.

The full text of this article is available in PDF format.

* The immunoglobulin studies and paraprotein characterization were performed in the laboratory of Robert A. Kyle, M.D., and the immunoperoxidase studies, by Peter M. Banks, M.D.


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