This article has been peer reviewed and approved by Michael Fisher, MD, Professor of Medicine, Albert Einstein College of Medicine. Review date: April 2009.
Mr. Asarch and Drs. Ashby-Richardson and Norden report no conflict of interest. Dr. Thiele is a consultant for Colgate-Palmolive Company. This relationship is not relevant to this article. The authors report no discussion of off-label use. Dr. Fisher reports no conflict of interest. The staff of CCME of Albert Einstein College of Medicine and Cutis® have no conflicts of interest with commercial interest related directly or indirectly to this educational activity. Mr. Asarch is a medical student, Tufts University School of Medicine, Boston, Massachusetts. Dr. Thiele was a dermatology resident, Dr. Ashby-Richardson is a pathology resident, and Dr. Norden is Assistant Professor of Dermatology, all from Tufts Medical Center, Boston. Dr. Thiele currently is a fellow, Dermatology Associates, Birmingham, Alabama. This case was presented in part at a meeting of the New England Dermatological Society; December 1, 2007; Boston, Massachusetts.
Adam Asarch, BA; Jens J. Thiele, MD, PhD; Harty Ashby-Richardson, DO; Pamela S. Norden, MD, MBA
Xanthogranuloma (XG) is a rare, non–Langerhans cell histiocytosis (LCH) that most commonly presents in infancy or early childhood. The condition is typified by the formation of reddish to yellow papules and nodules that are usually solitary. Xanthogranuloma rarely occurs in adults with immunohistochemical features similar to those seen in juvenile XG. Lesions in the adult form also are typically solitary. We describe a 70-year-old white man who presented with widespread flat-topped, reddish to yellow papules and nodules with histologic and immunohistochemical findings consistent with XG. We explore the pathogenesis, differential diagnosis, prognosis, and treatment of this rare eruption. Comparison of adult and juvenile XG will facilitate a better understanding of the disease. Although rare, XG is an important disease to consider in the differential diagnosis of xanthomatous disease in adults.
