title: Case of recalcitrant necrobiotic xanthogranuloma.
abstract: A 53-year-old woman with necrobiotic xanthogranuloma presented as infiltrated eyelid plaques, with later development of arm and thigh lesions. Clinical features, including association with immunoglobulin G-kappa paraprotein, and pathological findings were typical of this disorder. Treatment for 15 months with varying combinations of prednisone and multiple chemotherapeutic agents (melphalan, cyclophosphamide and chlorambucil) has led to minimal or no improvement in the clinical lesions or paraprotein. The case demonstrates some of the difficulties in managing this unusual disorder.
authors.affiliation: Department of Dermatology, Royal Newcastle Hospital, Newcastle, New South Wales, Australia. jillian_wells@bigpond.com
authors.forename: Jillian
authors.initials: J
authors.lastname: Wells
authors.forename: Rod
authors.initials: R
authors.lastname: Gillespie
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Zardawi
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005143:Eyelids; D005260:Female; D006099:Granuloma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D017441:Necrobiotic Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014973:Xanthomatosis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
chemical_list: D000893:Anti-Inflammatory Agents