An 82-year-old woman presented with a 9-month history of multiple, well-defined skin lesions on her neck and upper chest, progressively increasing in size. Histological examination of a skin biopsy showed a regular epidermis. In the dermis, granulomatous changes with central necrobiosis were found which extended focally into the subcutaneous fat. The necrobiotic areas were surrounded by Touton ...

A 46-year-old woman with a medical history of a multinodular goiter presented to the department of dermatology with extensive yellow papules and nodules surrounding both eyelids that had developed over the past 3 years. A skin biopsy was done that showed chronic granulomatous dermal inflammation and foreign body giant reaction consistent with juvenile xanthogranuloma after ruling out a ruptured...

Figure 1. Dermatological lesions.

Clinical record A 51-year-old woman was referred to hospital after an incidental fi nding of abnormal liver function test results (γ-glutamyl transpeptidase, 271 U/L [reference interval (RI), < 60 U/L]; alkaline phosphatase, 220 U/L [RI, 30–110 U/L]; hepatic transaminases, normal), acute renal impairment (urea, 11.7 mmol/L [RI, 2.7–8.0 mmol/L]; creatinine, 207 μmol/L [RI, 50–100 μmol/L]) and el...

Xanthomas are a common manifestation of lipid metabolism disorders. They include hyperlipemic xanthoma, normolipemic xanthoma, and a related condition, necrobiotic xanthogranuloma (NXG). All 3 forms can be associated with monoclonal immunoglobulin (MIg). In an attempt to improve diagnosis, understanding, and treatment of this association, we retrospectively analyzed a personal series of 24 pati...