PMC5892313_01
Pretreatment clinical findings of periorbital necrobiotic xanthogranuloma demonstrating multiple yellow, firm papules coalescing into plaques and resulting in cicatricial lagophthalmos.
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F1
Examination revealed yellow, firm papules coalescing into plaques causing cicatricial lagophthalmos, with surrounding erythema, and bilateral periorbital edema (Fig. 1).
Skin biopsy of necrobiotic xanthogranuloma lesions revealing a diffuse dermal infiltrate of histiocytes with multinucleated giant cells along with cholesterol clefts, Touton forms, and geographic necrobiosis. Hematoxylin and eosin, x100.
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F2
Numerous Touton and foreign-body type multinucleated giant cells were present, consistent with NXG (Fig. 2).
Treatment outcome of periorbital lesions of necrobiotic xanthogranuloma after 16 cycles of intravenous immunoglobulin.
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F3
She continues to receive monthly injections of IVIG with favorable results at 4 years of follow-up (Fig. 3).