A cutaneous necrobiotic disorder characterized by firm, yellow plaques or nodules, often in a periorbital distribution. It is often accompanied by an elevated ERYTHROCYTE SEDIMENTATION RATE; LEUKOPENIA; and MONOCLONAL GAMMOPATHY (IgG-kappa type) and systemic involvement.
Benign disorder of infants and children caused by proliferation of HISTIOCYTES, macrophages found in tissues. These histiocytes, usually lipid-laden non-Langerhans cells, form multiple yellow-red nodules most often in the skin, the eye, and sometimes in the viscera. Patients appear to have normal lipid metabolism and are classified as a normolipemic non-Langerhans cell histiocytosis.
A group of disorders characterized by swelling, basophilia, and distortion of collagen bundles in the dermis.
A condition marked by the development of widespread xanthomas, yellow tumor-like structures filled with lipid deposits. Xanthomas can be found in a variety of tissues including the SKIN; TENDONS; joints of KNEES and ELBOWS. Xanthomatosis is associated with disturbance of LIPID METABOLISM and formation of FOAM CELLS.
Diseases of the bony orbit and contents except the eyeball.
A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents.
A bony prominence situated on the upper surface of the body of the sphenoid bone. It houses the PITUITARY GLAND.
Eyelid diseases refer to various medical conditions that affect the function, structure, or appearance of the eyelids, including inflammatory, infectious, neoplastic, congenital, and traumatic disorders, which can impact vision, comfort, and overall ocular health.
Neoplasms of the base of the skull specifically, differentiated from neoplasms of unspecified sites or bones of the skull (SKULL NEOPLASMS).
General disorders of the sclera or white of the eye. They may include anatomic, embryologic, degenerative, or pigmentation defects.
A benign pituitary-region neoplasm that originates from Rathke's pouch. The two major histologic and clinical subtypes are adamantinous (or classical) craniopharyngioma and papillary craniopharyngioma. The adamantinous form presents in children and adolescents as an expanding cystic lesion in the pituitary region. The cystic cavity is filled with a black viscous substance and histologically the tumor is composed of adamantinomatous epithelium and areas of calcification and necrosis. Papillary craniopharyngiomas occur in adults, and histologically feature a squamous epithelium with papillations. (From Joynt, Clinical Neurology, 1998, Ch14, p50)
Neoplasms of the bony orbit and contents except the eyeball.

Complete response to thalidomide and dexamethasone in a patient with necrobiotic xanthogranuloma associated with monoclonal gammopathy: a case report and review of the literature. (1/3)

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Letter: Necrobiotic xanthogranuloma of extremities in an elderly patient successfully treated with low-dose prednisolone. (2/3)

We describe a 93-year-old Japanese woman who developed a painful yellowish plaque with reddish border on her left lower leg. Histological evaluation demonstrated hyaline necrobiosis and granulomatous lesions composed of histiocytes (some with foamy cytoplasm), multinucleated giant cells, and numerous cholesterol crystals. Serum electrophoresis displayed the presence of an M-peak with IgG lambda paraproteinemia. There was progressive ulcer formation in the location of the biopsy on the left leg. Multiple tender red dermal and subcutaneous skin nodules developed on her extremities. Oral administration of prednisolone 20 mg daily (0.5 mg/kg) was started. After 4 weeks, she obtained resolution of the skin lesions.  (+info)

Necrobiotic xanthogranuloma. (3/3)

Necrobiotic xanthogranuloma (NXG) is a rare, chronic, progressive, non-Langerhans histiocytosis that is strongly associated with hematologic malignant conditions. Only about 100 cases have been reported in the literature since it was first described in 1980. It is important for dermatologists to recognize NXG and initiate a prompt hematologic evaluation. IgG kappa is the most frequently discovered monoclonal gammopathy (65%), followed by IgG lambda (35%), and, much less commonly, IgA. Although no modality has been shown to be consistently effective, therapeutic options include glucocorticoids (topical, intralesional, and/or systemic), alkylating agents (chlorambucil and cyclophosphamide). interferon alpha, antimetabolites, antibiotics, thalidomide, and plasmaphersis.  (+info)

Necrobiotic xanthogranuloma (NXG) is a rare, progressive inflammatory disorder characterized by the formation of distinctive granulomatous lesions in the skin and occasionally in various visceral organs. The term "necrobiotic" refers to the presence of necrotic tissue within the lesions, while "xanthogranuloma" indicates the accumulation of foamy histiocytes (a type of white blood cell) and multinucleated giant cells.

The pathogenesis of NXG is not entirely understood, but it has been associated with monoclonal gammopathies, particularly those involving the M-protein IgG4. The disease typically affects middle-aged to older adults, with a slight female predominance.

Clinically, NXG presents as yellowish-red or violaceous papules, plaques, or nodules, often located on the periorbital area, eyelids, and less frequently on the trunk and extremities. The lesions may be asymptomatic or associated with mild pruritus, burning sensation, or pain. In some cases, NXG can lead to serious complications such as sight-threatening ocular involvement, kidney dysfunction, or neurological symptoms due to systemic dissemination.

Histopathologically, NXG lesions are characterized by the presence of necrobiotic areas surrounded by palisading histiocytes, T lymphocytes, and multinucleated giant cells, often with a cholesterol clefts and calcifications. The accumulation of foamy histiocytes is a hallmark feature of NXG.

The diagnosis of NXG is based on the clinical presentation, histopathological findings, and laboratory investigations to exclude associated conditions such as monoclonal gammopathies or other systemic disorders. Treatment options for NXG include topical and intralesional corticosteroids, systemic immunosuppressive agents, and targeted therapies against the underlying clonal gammopathy if present. Regular follow-up is essential to monitor disease progression and response to treatment.

Juvenile xanthogranuloma (JXG) is a rare, benign type of histiocytic tumor that typically presents in infancy or early childhood. It is characterized by the proliferation of lipid-laden macrophages called xanthoma cells, along with Touton giant cells and other inflammatory cells. JXG usually appears as a single or multiple, firm, yellowish to reddish-brown papules or nodules on the skin. While most cases of JXG are self-limited and resolve without treatment, some may involve extracutaneous sites such as the eyes, mouth, bones, and internal organs, which can lead to complications. The exact cause of JXG remains unknown, but it is not considered a hereditary condition.

Necrobiotic disorders are a group of medical conditions characterized by the presence of necrosis (tissue death) and inflammation in various organs and tissues. These disorders can be caused by different underlying etiologies, including infections, autoimmune diseases, vasculitis, and malignancies.

One example of a necrobiotic disorder is necrobiosis lipoidica, which primarily affects the skin. It is a chronic inflammatory condition that typically presents as one or more well-circumscribed, yellowish-brown plaques with central atrophy and telangiectasia, often located on the lower legs. The lesions may be asymptomatic or tender to the touch, and they can ulcerate in some cases.

Another example is necrotizing fasciitis, a rapidly progressive and potentially life-threatening infection that involves the fascia and subcutaneous tissue. It is often caused by group A Streptococcus or other bacterial pathogens and requires prompt surgical intervention and antibiotic therapy to prevent further spread of the infection and potential sepsis.

Other necrobiotic disorders include necrotizing vasculitis, which affects blood vessels and can lead to tissue damage and organ dysfunction, and necrobiotic xanthogranuloma, a rare inflammatory condition that primarily affects the skin but can also involve other organs such as the eyes, kidneys, and liver.

Overall, necrobiotic disorders are complex medical conditions that require careful evaluation and management by healthcare professionals with expertise in the relevant fields.

Xanthomatosis is a medical term that refers to the condition characterized by the presence of xanthomas, which are yellowish, fat-laden deposits that form under the skin or in other tissues. These deposits consist of lipids, such as cholesterol and triglycerides, and immune cells called macrophages, which have engulfed the lipids.

Xanthomas can occur in various parts of the body, including the eyelids, tendons, joints, and other areas with connective tissue. They may appear as small papules or larger nodules, and their size and number can vary depending on the severity of the underlying disorder.

Xanthomatosis is often associated with genetic disorders that affect lipid metabolism, such as familial hypercholesterolemia, or with acquired conditions that cause high levels of lipids in the blood, such as diabetes, hypothyroidism, and certain liver diseases. Treatment typically involves addressing the underlying disorder and controlling lipid levels through dietary changes, medications, or a combination of both.

Orbital diseases refer to a group of medical conditions that affect the orbit, which is the bony cavity in the skull that contains the eye, muscles, nerves, fat, and blood vessels. These diseases can cause various symptoms such as eyelid swelling, protrusion or displacement of the eyeball, double vision, pain, and limited extraocular muscle movement.

Orbital diseases can be broadly classified into inflammatory, infectious, neoplastic (benign or malignant), vascular, traumatic, and congenital categories. Some examples of orbital diseases include:

* Orbital cellulitis: a bacterial or fungal infection that causes swelling and inflammation in the orbit
* Graves' disease: an autoimmune disorder that affects the thyroid gland and can cause protrusion of the eyeballs (exophthalmos)
* Orbital tumors: benign or malignant growths that develop in the orbit, such as optic nerve gliomas, lacrimal gland tumors, and lymphomas
* Carotid-cavernous fistulas: abnormal connections between the carotid artery and cavernous sinus, leading to pulsatile proptosis and other symptoms
* Orbital fractures: breaks in the bones surrounding the orbit, often caused by trauma
* Congenital anomalies: structural abnormalities present at birth, such as craniofacial syndromes or dermoid cysts.

Proper diagnosis and management of orbital diseases require a multidisciplinary approach involving ophthalmologists, neurologists, radiologists, and other specialists.

A granuloma is a small, nodular inflammatory lesion that occurs in various tissues in response to chronic infection, foreign body reaction, or autoimmune conditions. Histologically, it is characterized by the presence of epithelioid macrophages, which are specialized immune cells with enlarged nuclei and abundant cytoplasm, often arranged in a palisading pattern around a central area containing necrotic debris, microorganisms, or foreign material.

Granulomas can be found in various medical conditions such as tuberculosis, sarcoidosis, fungal infections, and certain autoimmune disorders like Crohn's disease. The formation of granulomas is a complex process involving both innate and adaptive immune responses, which aim to contain and eliminate the offending agent while minimizing tissue damage.

The Sella Turcica, also known as the Turkish saddle, is a depression or fossa in the sphenoid bone located at the base of the skull. It forms a housing for the pituitary gland, which is a small endocrine gland often referred to as the "master gland" because it controls other glands and makes several essential hormones. The Sella Turcica has a saddle-like shape, with its anterior and posterior clinoids forming the front and back of the saddle, respectively. This region is of significant interest in neuroimaging and clinical settings, as various conditions such as pituitary tumors or other abnormalities may affect the size, shape, and integrity of the Sella Turcica.

Eyelid diseases refer to a variety of medical conditions that affect the function and/or appearance of the eyelids. These can include structural abnormalities, such as entropion (inward turning of the eyelid) or ectropion (outward turning of the eyelid), as well as functional issues like ptosis (drooping of the upper eyelid). Other common eyelid diseases include blepharitis (inflammation of the eyelid margin), chalazion (a blocked oil gland in the eyelid), and cancerous or benign growths on the eyelid. Symptoms of eyelid diseases can vary widely, but often include redness, swelling, pain, itching, tearing, and sensitivity to light. Treatment for these conditions depends on the specific diagnosis and may range from self-care measures and medications to surgical intervention.

Skull base neoplasms refer to abnormal growths or tumors located in the skull base, which is the region where the skull meets the spine and where the brain connects with the blood vessels and nerves that supply the head and neck. These neoplasms can be benign (non-cancerous) or malignant (cancerous), and they can arise from various types of cells in this area, including bone, nerve, glandular, and vascular tissue.

Skull base neoplasms can cause a range of symptoms depending on their size, location, and growth rate. Some common symptoms include headaches, vision changes, hearing loss, facial numbness or weakness, difficulty swallowing, and balance problems. Treatment options for skull base neoplasms may include surgery, radiation therapy, chemotherapy, or a combination of these approaches. The specific treatment plan will depend on the type, size, location, and stage of the tumor, as well as the patient's overall health and medical history.

Scleral diseases refer to conditions that affect the sclera, which is the tough, white outer coating of the eye. The sclera helps to maintain the shape of the eye and provides protection for the internal structures. Scleral diseases can cause inflammation, degeneration, or thinning of the sclera, leading to potential vision loss or other complications. Some examples of scleral diseases include:

1. Scleritis: an inflammatory condition that causes pain, redness, and sensitivity in the affected area of the sclera. It can be associated with autoimmune disorders, infections, or trauma.
2. Episcleritis: a less severe form of inflammation that affects only the episclera, a thin layer of tissue overlying the sclera. Symptoms include redness and mild discomfort but typically no pain.
3. Pinguecula: a yellowish, raised deposit of protein and fat that forms on the conjunctiva, the clear membrane covering the sclera. While not a disease itself, a pinguecula can cause irritation or discomfort and may progress to a more severe condition called a pterygium.
4. Pterygium: a fleshy growth that extends from the conjunctiva onto the cornea, potentially obstructing vision. It is often associated with prolonged sun exposure and can be removed surgically if it becomes problematic.
5. Scleral thinning or melting: a rare but serious condition where the sclera degenerates or liquefies, leading to potential perforation of the eye. This can occur due to autoimmune disorders, infections, or as a complication of certain surgical procedures.
6. Ocular histoplasmosis syndrome (OHS): a condition caused by the Histoplasma capsulatum fungus, which can lead to scarring and vision loss if it involves the macula, the central part of the retina responsible for sharp, detailed vision.

It is essential to consult an ophthalmologist or eye care professional if you experience any symptoms related to scleral diseases to receive proper diagnosis and treatment.

A craniopharyngioma is a type of brain tumor that develops near the pituitary gland, which is a small gland located at the base of the brain. These tumors arise from remnants of Rathke's pouch, an embryonic structure involved in the development of the pituitary gland.

Craniopharyngiomas are typically slow-growing and benign (non-cancerous), but they can still cause significant health problems due to their location. They can compress nearby structures such as the optic nerves, hypothalamus, and pituitary gland, leading to symptoms like vision loss, hormonal imbalances, and cognitive impairment.

Treatment for craniopharyngiomas usually involves surgical removal of the tumor, followed by radiation therapy in some cases. Regular follow-up with a healthcare team is essential to monitor for recurrence and manage any long-term effects of treatment.

Orbital neoplasms refer to abnormal growths or tumors that develop in the orbit, which is the bony cavity that contains the eyeball, muscles, nerves, fat, and blood vessels. These neoplasms can be benign (non-cancerous) or malignant (cancerous), and they can arise from various types of cells within the orbit.

Orbital neoplasms can cause a variety of symptoms depending on their size, location, and rate of growth. Common symptoms include protrusion or displacement of the eyeball, double vision, limited eye movement, pain, swelling, and numbness in the face. In some cases, orbital neoplasms may not cause any noticeable symptoms, especially if they are small and slow-growing.

There are many different types of orbital neoplasms, including:

1. Optic nerve glioma: a rare tumor that arises from the optic nerve's supportive tissue.
2. Orbital meningioma: a tumor that originates from the membranes covering the brain and extends into the orbit.
3. Lacrimal gland tumors: benign or malignant growths that develop in the lacrimal gland, which produces tears.
4. Orbital lymphangioma: a non-cancerous tumor that arises from the lymphatic vessels in the orbit.
5. Rhabdomyosarcoma: a malignant tumor that develops from the skeletal muscle cells in the orbit.
6. Metastatic tumors: cancerous growths that spread to the orbit from other parts of the body, such as the breast, lung, or prostate.

The diagnosis and treatment of orbital neoplasms depend on several factors, including the type, size, location, and extent of the tumor. Imaging tests, such as CT scans and MRI, are often used to visualize the tumor and determine its extent. A biopsy may also be performed to confirm the diagnosis and determine the tumor's type and grade. Treatment options include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

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