Papular xanthoma. A clinical, histologic, and ultrastructural study

Papular Xanthoma

“…In our case iron staining was negative as were S-100 protein and lysozyme reactions: so it seems to us that these stains cannot be relied upon to differentiate PX from other entities. Ultrastructurally our case showed a picture similar to that ob served by Sanchez et al [5]: the infiltrate cells are macrophages packed with free intracytoplasmic lipidic droplets; the only difference was that lipidic vacuoles were not electron-dense and myelinated and lam inat ed bodies were completely absent. However in the case of Sanchez et al the latter were so abundant that they claimed that they could be a characteristic marker of PX, a finding we cannot substantiate.…”

“…Winkelman [1,2] found that iron staining in PX shows a nega tive reaction and considers it helpful in its differential diagnosis. Nevertheless it must be stressed that some cases of PX described under different misdiagnosis [3,4] show positive reactions, a finding recently con firmed by Sanchez et al [5] in a typical case of PX. The same authors also found that foamy cells were negative for S-100 protein and for lysozyme with the exception of a specimen which showed many cells positive for lysozyme.…”

“…Despite the fact that PX is a new entity of which few cases have been observed [1,2,5,6], we think that the features pointed out by Winkelman as typical of this form allow a clinical and histological differentiation from other normolipemic xanthomatosis and histiocytosis with secondary lipidization. XD is the condition most frequently confused with PX [3].…”

“…Ac cording to Winkelman [1,2] some cases reported under the diagnosis of xanthoma disseminatum (XD) [3] and progressive shows macrophages packed with free lipidie nodular histiocytoma [4] can be better clas sified as PX. Apart from these only 1 further case of PX has been described [5] and this entity is not yet included in der matological textbooks. We present a case of PX with histochemical and ultrastructural findings.…”

Plaque‐like papular xanthoma: a new variant of non‐Langerhans cell disease

“…She has now been followed up for 3 years and no blood cell dyscrasia has been found. PX 3,5,6,7,8 is a rare n-LCD, affecting the skin and eventually the oral mucosa, as an eruption of 2-15 mm papulonodular lesions occurring on the trunk, face and scalp with no tendency to coalesce or form plaques. Histopathology demonstrates a monomorphous infiltrate of foamy macrophages and scarce Touton cells, with scant to absent inflammatory infiltrate.…”