case_images: PMC5892313_01
case_images: Pretreatment clinical findings of periorbital necrobiotic xanthogranuloma demonstrating multiple yellow, firm papules coalescing into plaques and resulting in cicatricial lagophthalmos.
case_images: cop-0009-0070-g01.jpg
case_images: PMC5892313_01_cop-0009-0070-g01.jpg
case_images: F1
case_images: Examination revealed yellow, firm papules coalescing into plaques causing cicatricial lagophthalmos, with surrounding erythema, and bilateral periorbital edema (Fig. 1).
case_images: Skin biopsy of necrobiotic xanthogranuloma lesions revealing a diffuse dermal infiltrate of histiocytes with multinucleated giant cells along with cholesterol clefts, Touton forms, and geographic necrobiosis. Hematoxylin and eosin, x100.
case_images: cop-0009-0070-g02.jpg
case_images: PMC5892313_01_cop-0009-0070-g02.jpg
case_images: F2
case_images: Numerous Touton and foreign-body type multinucleated giant cells were present, consistent with NXG (Fig. 2).
case_images: Treatment outcome of periorbital lesions of necrobiotic xanthogranuloma after 16 cycles of intravenous immunoglobulin.
case_images: cop-0009-0070-g03.jpg
case_images: PMC5892313_01_cop-0009-0070-g03.jpg
case_images: F3
case_images: She continues to receive monthly injections of IVIG with favorable results at 4 years of follow-up (Fig. 3).