Adult xanthogranuloma diagnosed on reflectance confocal microscopy

Haroon, Attiya; Shafi, Shahram; Rao, Babar

doi:10.1111/cup.12971

Cited by 10 publications

(9 citation statements)

References 4 publications

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“…PLD and RCM are useful tools for the in vivo diagnosis of XG 7–12. In our case, the dermoscopy and RCM features were similar to those reported in single lesions of XG 7–12.…”

Section: Discussionsupporting

confidence: 85%

“…PLD and RCM are useful tools for the in vivo diagnosis of XG 7–12. In our case, the dermoscopy and RCM features were similar to those reported in single lesions of XG 7–12. The homogeneous orange-yellowish hue seen at dermoscopy is related to the histopathological presence of foamy histiocytes and Touton giant cells; the last typically appear at RCM as peculiar giant cells surrounded by highly refractive ring due to the cytoplasm rich of lipids.…”

Section: Discussionsupporting

confidence: 83%

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Multiple xanthogranulomas in an adult patient: clinical, dermoscopic, reflectance confocal microscopy and histopathological features

et al. 2019

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A case of multiple xanthogranulomas located bilaterally on arms, armpits, legs, trunk, abdomen, scalp, neck and plantar surfaces in a 25-year-old man is reported. The patient was evaluated by polarised light dermoscopy and reflectance confocal microscopy (RCM) that showed peculiar aspects. In particular, dermoscopy showed a homogeneous orange-yellowish hue that is related to the histopathological presence of foamy histiocytes and Touton giant cells; the last typically appeared at RCM as peculiar giant cells surrounded by highly refractive ring due to the cytoplasm rich of lipids. Laboratory investigations, including routine haematological examination, liver and renal function tests, serum lipid and sugar levels were normal. The patient started isotretinoin 20 mg once daily. After 6 months, some lesions flattened, leading to yellowish or hyperpigmented macules, but new lesions raised up.

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“…PLD and RCM are useful tools for the in vivo diagnosis of XG 7–12. In our case, the dermoscopy and RCM features were similar to those reported in single lesions of XG 7–12.…”

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 83%

Multiple xanthogranulomas in an adult patient: clinical, dermoscopic, reflectance confocal microscopy and histopathological features

et al. 2019

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“…Our finding from LC‐OCT in the horizontal mode was comparable to previous studies using RCM [ 11 , 12 , 13 , 14 ]. Differently from RCM, LC‐OCT also enables the vertical mode, allowing the possibility to combine images and data from two different observation points.…”

Section: Discussionsupporting

confidence: 90%

Line‐field confocal optical coherence tomography of xanthogranuloma: Correlation with vertical and horizontal histopathology

et al. 2021

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Line‐field confocal optical coherence tomography (LC‐OCT) is a new noninvasive technique for a real‐time, vertical, and horizontal imaging of the skin at cellular resolution. A 47‐year‐old female presented with a 6‐month history of an asymptomatic yellowish papule. LC‐OCT evaluation was able to show the diagnostic microscopic features of xanthogranuloma and showed an excellent correlation with vertical and horizontal histopathological sections by revealing enlarged dermal papillae containing multiple, bright roundish giant cells, corresponding to foamy histiocytes, and giant cells characterized by a dark center surrounded by a highly hyper‐refractile peripheral ring, corresponding to Touton cells. LC‐OCT may represent a valid, noninvasive alternative to histopathological examination in clinically atypical cases of xanthogranuloma.

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“…The vessels were seen on the surface of the tumors and they ran from the periphery to the center of the lesions in the majority of cases. Small comma-shaped vessels at the periphery described in adult JXG were not detected in our pediatric population of JXG (19). There was a high frequency of linear vessels in the early and developed stages, but not in the late stage.…”

Section: Discussioncontrasting

confidence: 59%

Dermoscopic Patterns in Juvenile Xanthogranuloma Based on the Histological Classification

2021

Front. Med.

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Background: Several dermoscopic features of juvenile xanthogranuloma (JXG) have been previously described in single cases or small case series and need to be further verified in a large sample.Objective: We aimed to investigate the dermoscopic patterns of JXG in a large case series and the correlations of these with clinical features of different histopathological subtypes of JXG.Methods: Patients who underwent dermoscopic evaluation and had a histopathological diagnosis of JXG were recruited. Histological findings, including stage and Ki67 proliferative index and the dermoscopic features of each lesion were recorded.Results: Forty-one patients with JXG were included. The male to female ratio was 1.28: 1 and the median age of onset was 11 months (range: 0–95 months). Fourteen lesions were histologically categorized in the early stage, 17 in the developed stage, and 10 in the late stage. The “setting sun” pattern was observed in 35 lesions (85.4%) and “clouds” of paler yellow areas in 26 lesions (63.4%). The frequency of the “setting sun” pattern was higher in the early and developed stages (30/31) than in the late stage (5/10) (P = 0.002), while that of “clouds” of paler yellow areas was not significantly different between each stage. Branched linear vessels were detected in the early (11/14) and developed stage (6/17), but not in the late stage. The mean Ki67 index of the lesions with linear vessels was 11.8% (range: 2–40%), which was higher than that of lesions without linear vessels (mean index: 5%, range: 1–30%) (P = 0.005). The pigment network and whitish areas were only detected in 6 and 5 lesions in the late stage, respectively. The whitish areas presented either as streak or stellate shape. The pigment network exhibited either in a centric or a peripheral pattern.Conclusions: The “setting sun” pattern is the characteristic dermoscopic features of JXG in the early and developed stages, while whitish areas and pigment network are the characteristic patterns in the late stage. Linear vessels present as branched patterns and mostly occur in the early stage with a high proliferative index, indicating rapid growth. The whitish areas and pigment network may present in various patterns. Dermoscopy is a useful adjunctive tool in the diagnosis and staging of JXG.

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Adult xanthogranuloma diagnosed on reflectance confocal microscopy

Cited by 10 publications

References 4 publications

Multiple xanthogranulomas in an adult patient: clinical, dermoscopic, reflectance confocal microscopy and histopathological features

Multiple xanthogranulomas in an adult patient: clinical, dermoscopic, reflectance confocal microscopy and histopathological features

Line‐field confocal optical coherence tomography of xanthogranuloma: Correlation with vertical and horizontal histopathology

Dermoscopic Patterns in Juvenile Xanthogranuloma Based on the Histological Classification

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