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May 2016

Necrobiotic Xanthogranuloma Treated With Topical Nitrogen Mustard (Mechlorethamine)

Author Affiliations
  • 1Perelman School of Medicine at the University of Pennsylvania, Philadelphia
  • 2Dermatology and Skin Surgery Center, Kennett Square, Pennsylvania
  • 3Abramson Cancer Center, University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia
  • 4Perelman School of Medicine at the University of Pennsylvania, Department of Dermatology, Philadelphia
JAMA Dermatol. 2016;152(5):589-590. doi:10.1001/jamadermatol.2015.5151

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.

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