Worsening bilateral periorbital discoloration
A 44 y-o female presented with a 2-year history of worsening bilateral periorbital discoloration, pain, and swelling. Examination revealed yellow, firm plaques with surrounding erythema, and bilateral periorbital edema. Visual acuity, pupils, and extraocular motility were normal. What are your comments on the case?
Suggestive of "Periorbital Necrobiotic xanthogranuloma" NXG is a rare non-Langerhans histiocytosis with cutaneous manifestations, most commonly of the periorbital skin, and is often associated with hematologic disorders such as monoclonal gammopathy. Adv:- Biopsy
* Amyloidosis ** Eczematous dermatitis may be due some allergic reaction Needs further investigation and evaluation to conclude and line of treatment.
Bilateral recurrent exematous dermatitis most probably due to food allergy or drug allergy
Necrobiotic xanthogranuloma No first-line NXG therapy has been established. The recommended therapies of corticosteroids (intralesional and/or systemic), alkylating agents (such as cyclophosphamide, melphalan, or chlorambucil), interferon alfa, antimetabolites, antimicrobial treatment, and plasmapheresis have shown inconsistent success.
SUGGESTIVE OF PERIORBITAL AMYLOIDOSIS.... ... POSSIBLY... MYELOMA. ASSOCIATED... ADVISABLE BIOPSY....FOR. EARLY. DIAGNOSIS
DD:- Dermatitis, Fungal infection, Amyloidosis. Autoimmune disorders like SLE must be ruled out.
Chronic periorbital Eczematous dermatitis secondary to to Fungal infection
Amyloidosis.gradual discoloration around the eyes due to slow capillary ooze.
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