Diffuse (Generalized) Plane Xanthoma Misdiagnosed as Carotenoderma: Usefulness of Reflectance Confocal Microscopy

Abstract

Diffuse (generalized) plane xanthoma is a rare normolipemic xanthomatosis, frequently associated with multiple myeloma and monoclonal gammopathy. Its clinical presentation is well described, and in most cases, clinical suspicion is immediate. Rarely, it can clinically present with a diffuse and uniform yellowish discoloration, and in this context, several investigations are required to identify the correct diagnosis. We describe a case characterized by progressive diffuse yellow–orange discoloration lasting about 3 years and classified as carotenoderma in which reflectance confocal microscopy addressed the diagnosis and drove the correct selection of the biopsy site. Definitive diagnosis of diffuse (generalized) plane xanthoma was confirmed later by histological examination.

Topical Simvastatin Improves Lesions of Diffuse Normolipemic Plane Xanthoma by Inhibiting Foam Cell Pyroptosis

“…Diffuse plane xanthoma (DPX) is clinically characterized by large, flat, plaque-like, yellow-to-orange skin lesions that are mostly symmetrically distributed over the axillae, neck, shoulders, or buttocks ( 1 ). DPX not only seriously affects the patients’ quality of life, but is also associated with systemic diseases, such as monoclonal gammopathy, which may lead to death ( 2 – 4 ).…”