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Other infiltrative conditions
Published in Aimilios Lallas, Enzo Errichetti, Dimitrios Ioannides, Dermoscopy in General Dermatology, 2018
Enzo Errichetti, Aimilios Lallas
Moving to NLCHs, they are often divided into forms with exclusive/predominant skin involvement (juvenile and adult-onset xanthogranuloma, papular xanthoma, generalized eruptive histiocytosis, benign cephalic histiocytosis, solitary and diffuse cutaneous reticulohistiocytosis, and progressive nodular histiocytosis) and forms with common systemic involvement (xanthoma disseminatum, Erdheim–Chester disease, multicentric reticulohistiocytosis, necrobiotic xanthogranuloma, and Rosai–Dorfman disease).2 From a dermatological point of view, all such conditions usually present with red-orangish, red-brown, or yellowish papules/nodules, whose localization varies according to the subtype, although the head, trunk, and skin folds are generally the most commonly involved sites.2 Interestingly, forms with exclusive/predominant skin involvement tend to have discrete (nonconfluent) lesions, while forms with extracutaneous involvement often display lesions that form groups or merge into plaques.2
Proceedings of the 42nd Annual and First Virtual Upper Midwest Neuro-Ophthalmology Group Meeting, 24 July 2020
Published in Neuro-Ophthalmology, 2020
Salma Yassine, Francisco R. Sanchez Moreno, John J. Chen, Collin McClelland
Neena Cherayil, MD, Northwestern University, described a 67-year-old male who was referred for evaluation of blurry vision and intermittent diplopia. He also noted concurrent enlargement of a testicular nodule. On examination, he was found to have bilateral disc oedema and diffuse ophthalmoplegia. Brain and orbital MRI showed diffuse enhancement of the extraocular muscles and thickening of the pachymeninges with infiltration of the right cavernous sinus. Orchiectomy was performed and pathology showed ill-defined necrotising and non-necrotising granulomas. A falx stereotactic intracranial biopsy was performed, which showed a low-grade B-cell proliferation with plasmacytes indicating lymphoma. Finally, a biopsy of skin lesions that appeared simultaneously with the onset of visual symptoms revealed findings of necrobiotic xanthogranuloma – a rare non-Langerhans cell histiocytosis. The patient was placed on rituximab with some improvement of vision.