Necrobiotic xanthogranuloma (NXG) is an uncommon skin disorder associated with a lymphoproliferative disorder that may be multisystemic.



(1) xanthogranulomas involving the trunk, flexures and periorbital region

(1a) plaques and subcutaneous nodules

(1b) tendency to ulcerate over time

(1c) may be yellow to brown in color

(2) presence of a lymphoproliferative disorder, often a plasma cell dyscrasia

(3) variable ocular symptoms: keratitis , scleritis, episcleritis, uveitis

(4) variable hepatosplenomegaly

(5) variable myocardial involvement

(6) variable mucosal involvement


Histologic features of skin lesions:

(1) palisading granuloma

(2) foreign-body and Touton giant cells

(3) cholesterol clefts

(4) necrobiosis

(5) foam cells


Laboratory findings:

(1) paraproteinemia

(2) variable cryoglobulinemia

(3) elevated erythocyte sedimentation rate (ESR)

(4) variable anemia and leucopenia

(5) low serum complement concentrations


To read more or access our algorithms and calculators, please log in or register.