A 42-year-old woman who had had erythematous, nodular lesions around both eyes for 1 year presented with an inability to open her eyes (Figure). On examination, large erythematous nodules with a partly xanthomatous hue were present over the periocular skin bilaterally. Multiple telengiectasias and areas of scaling were seen over the surface of the lesions. Anterior segment and fundus examination findings were within normal limits. Systemic investigations, including serum and urine protein electrophoresis, had unremarkable results. Skin biopsy findings were suggestive of proliferating histiocytic cells with occasional giant cells. Immunostaining showed strong positive results for CD 68.
Desai A, Singh P, Sen S. Periocular Necrobiotic Xanthogranuloma—A Case of Unseen Eyes. JAMA Ophthalmol. 2020;138(8):e194778. doi:10.1001/jamaophthalmol.2019.4778
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