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Reflectance Confocal Microscopy Can Help Differentiate Adult Xanthogranulomatous Disease from Xanthelasma—A Case Report

Year: 2025

Type: article

Abstract: Background: Adult xanthogranulomatous disease (AXD) is a rare histiocytic disorder with systemic potential, while xanthelasma palpebrarum (XP) is a common xanthoma often linked to lipid disorders. Differentiating these conditions is challenging due to overlapping features. Reflectance confocal microscopy (RCM), a non-invasive imaging tool, offers high-resolution visualization of skin structures and may aid diagnosis. Methods: We present a 71-year-old woman with periocular lesions. RCM was used to evaluate the lesions, identifying cellular and structural features. The findings were confirmed through histopathology, followed by surgical excision. Postoperative monitoring utilized RCM and LC-OCT. Results: RCM identified Touton giant cells, foamy histiocytes, and fibrosis, helping to distinguish xanthogranuloma from xanthelasma. Histopathology confirmed the diagnosis, and the patient underwent successful lesion excision without complications. Conclusions: This case underscores RCM’s utility as a diagnostic adjunct for differentiating AXD from XP in sensitive regions like the periocular area. The combined use of RCM and LC-OCT enhances monitoring for recurrence. While histopathology remains the diagnostic gold standard, RCM shows promise as a non-invasive tool, warranting further research to validate its role and develop standardized clinical protocols.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm14041359

Authors: Larysa Krajewska-Węglewicz, Monika Dźwigała, Piotr Sobolewski, Anna Wasążnik-Jędras, Irena Walecka

Institution: National Medical Institute of the Ministry of Interior and Administration

Language: English

Topic: Histiocytic Disorders and Treatments

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137