Necrobiotic xanthogranuloma (NXG) is a chronic, progressive skin condition characterized by a granulomatous reaction with the potential to affect multiple organs that tends to be associated with paraproteinemia. Multiple treatments have been reported; herein, we present a case of extensive NXG successfully treated with topical nitrogen mustard (mechlorethamine).
A man in his 60s presented for treatment of striking violaceous and orange telangiectatic plaques and nodules circumferentially around the torso (Figure 1A). Thin, yellow plaques were also observed around his eyelids. The patient was noted to have thinner indurated plaques and patches on his back with 20% of his body surface area affected.
Rodriguez O, Meyers C, Weiss BM, Elenitsas R, Rosenbach M. Necrobiotic Xanthogranuloma Treated With Topical Nitrogen Mustard (Mechlorethamine). JAMA Dermatol. 2016;152(5):589-590. doi:10.1001/jamadermatol.2015.5151