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Abueleinen KG, Marie MA, Abdel-Halim MRE. Blinding Xanthoma Disseminatum. Am J Ophthalmol 2023; 245:e3-e5. [PMID: 36216161 DOI: 10.1016/j.ajo.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/07/2022] [Accepted: 09/24/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Mohamed A Marie
- From kasr Alainy School of Medicine, Cairo University, Internal Medicine
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Kim J, Steeples LR, Jones NP. Ocular Involvement in the Histiocytoses: A Literature Review with an Illustrative Case Series. Ocul Immunol Inflamm 2021; 30:600-614. [PMID: 34637661 DOI: 10.1080/09273948.2021.1936566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: To describe and illustrate recent reclassification and clinical descriptions of the histiocytoses, diagnosis and management, and effects on the eye and adnexaePatients and methods: Literature review with an illustrative case series of seven patients with histiocytosis and ophthalmic involvement from a single tertiary centre.Results: Skin lesions with signs including eyelid mass, orbital bone destruction, bizarre keratic precipitates, limbal or iris mass, haemorrhagic anterior uveitis, subretinal lesions of uncertain etiology, ischaemic retinopathy, optic neuropathy, and apparent steroid-resistant inflammations should be comprehensively investigated.Conclusions: Ophthalmic involvement in histiocytosis is rare. Clinical manifestations vary from limited single-organ disease to lethal systemic infiltration or malignancy. Radiology may identify lesions for biopsy. Histology with appropriate markers is essential. Oncology advice may be required.
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Affiliation(s)
- Jennifer Kim
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Laura R Steeples
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Nicholas P Jones
- Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
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A Modified Surgical Method Combined with Blepharoplasty Design for Treatment of Xanthelasma Palpebrarum. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4803168. [PMID: 33313315 PMCID: PMC7721502 DOI: 10.1155/2020/4803168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/23/2020] [Accepted: 11/17/2020] [Indexed: 11/18/2022]
Abstract
Purpose Xanthelasma palpebrarum manifests as a yellowish placoid on the medial aspect of the upper eyelids, often in middle and old age. Aggravated lateral hooding of the eyelid might cause a deformity with conventional surgery, which appears to be more deficient on the medial side with excess hooding of the lateral skin. The authors suggest a novel surgical technique to solve this problem and reconstruct the defect appropriately. Methods From July 2017 to December 2018, our method of combining excision with blepharoplasty was performed on 8 patients, consisting of 15 lesions on the upper eyelid and 6 lesions on the lower lid. Lesion removal incorporating blepharoplasty incision was done. After resection, the orbicularis oculi musculocutaneous flap was widely elevated extending through the whole upper eyelid with the lateral flap first along with fat maneuver. The flap was advanced into the defect, with even distribution of tension, after lower flap fixation to the required height of the eyelid fold. Taping was done with a hydrocolloid bandage and kept for 2 weeks. Results The wounds were healed primarily, and no cases of recurrence, lagophthalmos, hypertrophic scar, pigmentation, or remarkable deformity were noted. All patients were satisfied, and the functional outcomes were excellent. Two patients had trivial complications specific to our method, that of triple fold and neo-Mongolian fold, which were simply revised later. Conclusions This modality overcame the drawbacks of eyelid deformity observed in previous surgical methods, giving excellent results without any critical complications.
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Behra A, Sa DK, Naik R, Patel RK. A Rare Case of Persistent Xanthoma Disseminatum without Any Systemic Involvement. Indian J Dermatol 2020; 65:239-241. [PMID: 32565577 PMCID: PMC7292467 DOI: 10.4103/ijd.ijd_435_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Akhilesh Behra
- Department of Dermatology, LSLAM Government Medical College, Raigarh, Chhattisgarh, India. E-mail:
| | - Dilip Kumar Sa
- Department of Dermatology, LSLAM Government Medical College, Raigarh, Chhattisgarh, India. E-mail:
| | - Reena Naik
- Department of Pathology, LSLAM Government Medical College, Raigarh, Chhattisgarh, India
| | - Rakesh Kumar Patel
- Department of Dermatology, LSLAM Government Medical College, Raigarh, Chhattisgarh, India. E-mail:
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Soundararajan V, Charny JW, Bain MA, Tsoukas MM. The color of skin: orange diseases of the skin, nails, and mucosa. Clin Dermatol 2019; 37:520-527. [PMID: 31896407 DOI: 10.1016/j.clindermatol.2019.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cutaneous disease can present with lesions of all colors of the visible spectrum. Lesions of the skin, nail, and mucous membranes with an orange color can be due to a variety of etiologies. The conditions may appear as purely orange, yellow-orange, red-orange, tan, or brown with an orange hue. The orange color may also present as a transient phase of a disease process. As with all dermatologic pathology, a key way to distinguish orange-colored lesions is by distribution and morphology. The sclera, palate, lips, gingiva, and nails may also be involved. A literature review using PubMed with keywords, including orange, skin, mucosa, cutaneous, xanthoderma, and granuloma, was conducted to gather all dermatologic conditions that can present with an orange color. The relevant diseases were categorized by etiology and include inflammatory, infectious, neoplastic, and exogenous causes.
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Affiliation(s)
- Vinaya Soundararajan
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Jacob W Charny
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Michelle A Bain
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Maria M Tsoukas
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA.
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Mustafa OM, Daoud YJ. Corneoscleral xanthogranuloma treated with chemotherapy: The room for nonsurgical management. Eur J Ophthalmol 2019; 30:NP23-NP26. [PMID: 30813780 DOI: 10.1177/1120672119832187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe a clinical case of corneoscleral xanthogranuloma, a rare manifestation of juvenile xanthogranuloma, and xanthoma disseminatum, which responded well to chemotherapy. METHODS Interventional case report and literature search. RESULTS A 9-year-old female patient with a disseminated disease showed complete regression of her corneoscleral xanthogranuloma with methotrexate and azathioprine therapy. CONCLUSION Since they are potentially blinding, corneoscleral xanthogranulomas are commonly surgically excised. While surgical resection has been widely advocated in the literature, immunosuppressive therapy alone may be a pertinent management line of corneoscleral xanthogranuloma, especially with systemic involvement.
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Affiliation(s)
- Osama M Mustafa
- Cornea, Cataract and Refractive Surgery Services, Division of Cornea, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Yassine J Daoud
- Cornea, Cataract and Refractive Surgery Services, Division of Cornea, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Banerjee M, Sharma P, Gaur N, Takkar B. Infiltrative chiasmatopathy in xanthoma disseminatum: a rare entity. BMJ Case Rep 2018; 11:11/1/e227207. [PMID: 30567219 DOI: 10.1136/bcr-2018-227207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mousumi Banerjee
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi, India
| | - Pradeep Sharma
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi, India
| | - Nripen Gaur
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi, India
| | - Brijesh Takkar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Wang ZS, Li J. Intertriginous Multiple Reddish-Brown Papulonodules. JAMA Dermatol 2018; 154:721-722. [PMID: 29641817 DOI: 10.1001/jamadermatol.2017.5833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Zhong-Shuai Wang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Li
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Histopathological and Clinical Findings in Cutaneous Manifestation of Erdheim–Chester Disease and Langerhans Cell Histiocytosis Overlap Syndrome Associated With the BRAFV600E Mutation. Am J Dermatopathol 2017; 39:493-503. [DOI: 10.1097/dad.0000000000000793] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Baykal C, Polat Ekinci A, Yazganoglu KD, Buyukbabani N. The clinical spectrum of xanthomatous lesions of the eyelids. Int J Dermatol 2017; 56:981-992. [PMID: 28500693 DOI: 10.1111/ijd.13637] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 03/10/2017] [Accepted: 03/21/2017] [Indexed: 12/11/2022]
Abstract
Yellowish papules, nodules, or plaques, namely "xanthomatous" lesions, may be seen on the eyelids in the course of various disorders. The prototype is "xanthelasma palpebrarum" (XP) that is localized only to the eyelids and may be associated with hyperlipidemia. On the other hand, different types of normolipemic disorders may also cause xanthomatous eyelid lesions. Among these, Langerhans cell histiocytosis, diffuse normolipemic xanthoma, and non-Langerhans cell histiocytoses (papular xanthoma, juvenile xanthogranuloma, xanthoma disseminatum, adult-onset xanthogranuloma, adult-onset asthma and periocular xanthogranuloma, necrobiotic xanthogranuloma, Erdheim-Chester disease, Rosai-Dorfman disease, and reticulohistiocytosis) can be listed. The eyelid findings of this heterogeneous group of disorders are challenging to differentiate from each other due to common clinical aspects that may even sometimes mimic XP. Nodularity, induration, ulceration, diffuse eyelid involvement, and extension from eyelids to the neighboring skin may represent the clinical features of xanthomatous lesions other than XP. It is necessary to obtain a thorough history and exclude XP and then perform detailed dermatological and systemic examination, biopsy for histopathologic confirmation, and appropriate specific imaging screens. As some of the conditions may be associated with other systemic disorders, especially malignancies, the differentiation of xanthomatous eyelid lesions has a critical importance, and clinical signs can be guiding.
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Affiliation(s)
- Can Baykal
- Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Algun Polat Ekinci
- Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Kurtulus D Yazganoglu
- Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Nesimi Buyukbabani
- Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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Das A, Podder I, Chandra S, Mondal AK, Jash P, Gharami RC. Firm Skin-Colored Nodules on the Scalp. Indian J Dermatol 2015; 60:425. [PMID: 26288461 PMCID: PMC4533592 DOI: 10.4103/0019-5154.160554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Anupam Das
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
| | - Indrashis Podder
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
| | - Somodyuti Chandra
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
| | - Ashim K Mondal
- Department of Dermatology, Burdwan Medical College, Burdwan, West Bengal, India
| | - Prabir Jash
- Department of Plastic Surgery, Medical College and Hospital, Kolkata, India
| | - Ramesh C Gharami
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
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Xanthoma disseminatum with tumor-like lesion on face. Case Rep Dermatol Med 2014; 2014:621798. [PMID: 25161777 PMCID: PMC4006584 DOI: 10.1155/2014/621798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 01/28/2014] [Indexed: 01/19/2023] Open
Abstract
Xanthoma disseminatum (XD) is a rare benign mucocutaneous xanthomatosis that is classified as a benign non-Langerhans cell histiocytosis. We report a 62-year-old man who presented with widespread yellow-brown papulonodular and tumoral lesions on face, flexors, and trunk. Histopathological features of the cutaneous lesions were typical of XD.
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Treatment of xanthelasma palpebrarum by upper eyelid skin flap incorporating blepharoplasty. Aesthetic Plast Surg 2013; 37:882-6. [PMID: 23943013 DOI: 10.1007/s00266-013-0195-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 06/30/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Wound repair after xanthelasma palpebrarum excision in the upper eyelid is a challenge for the plastic surgeon due to the difficulty obtaining tissue of the appropriate color and texture. The authors present their treatment of xanthelasma palpebrarum by an upper eyelid skin flap incorporating blepharoplasty with satisfactory results for 16 patients. METHODS From September 2004 to August 2012, 32 xanthelasma lesions in the upper eyelids of 16 patients were surgically excised, after which an orbicularis oculi muscle myocutaneous flap was formed in blepharoplasty. The flap was used to repair the defect resulting from excision of the lesion. The xanthelasma palpebrarum treatment and blepharoplasty were performed simultaneously. RESULTS No flap necrosis complications occurred after the operation. During a 3- to 12-months follow-up period, no lesion recurrence, lagophthalmos, hypertrophic scar, or bulky appearance was noted in any of the 16 patients. Aesthetic results in the upper eyelid were obtained for all the patients. CONCLUSION By the reported method, the "waste" skin in blepharoplasty can become "treasure" material for covering the defect resulting from lesion excision. No new donor area is required. The dual effects are excision of the xanthelasma lesion and a satisfactory cosmetic result in the upper eyelid. This procedure could be the preferred option for xanthelasma palpebrarum in the upper eyelid.
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Kim WJ, Ko HC, Kim BS, Kim MB. Successful treatment of xanthoma disseminatum with combined lipid lowering agents. Ann Dermatol 2012; 24:380-2. [PMID: 22879732 PMCID: PMC3412257 DOI: 10.5021/ad.2012.24.3.380] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 11/29/2011] [Accepted: 11/30/2011] [Indexed: 11/14/2022] Open
Affiliation(s)
- Won-Jeong Kim
- Department of Dermatology, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea
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