NECROBIOTIC XANTHOGRANULOMA PRESENTING AS A CLINICAL VARIANT WITHOUT PARAPROTEINEMIA

Necrobiotic xanthogranuloma is a rare granulomatous disease involving skin and subcutaneous tissues. A 61 year old woman presented with a 5 year history of enlarging plaques around both eyelids. it was associated with diminished vision in both eyes. The lesions are often bilateral, symmetrical and ophthalmologic complications are observed. A histopathological examination showed features of necrobiotic xanthogranuloma. Necrobiotic xanthogranuloma is usually associated with paraproteinemia which was not seen in our case. The pathogenesis remains unclear. Although there is no first line of treatment, reports have shown variable benefits with chemotherapeutic agent and steroids.