By David Loshak
Papular xanthoma has been confirmed as distinct, though rare, clinico-pathology among non-Langerhans cell histiocytoses of the skin. It is one of several clinico-pathological variants of normolipaemic cutaneous non-Langerhans cell histiocytoses, report dermatologists and other specialists at Lainz Municipal Hospital, Vienna, Austria and the University of Innsbruck, Austria.
They identified the clinical, histological and immunohistochemical characteristics of papular xanthoma. It represents a monomorphous reaction pattern marked by the presence of predominantly xanthomatised macrophages, the specialists say.
Results of 10 cases (m=8, f=2) of the condition were compared with other histological subtypes. These subtypes were the polymorphous and other monomorphous reaction patterns in non-Langerhans cell histiocytoses.
Clinically, the specialists said, papular xanthoma presented mainly as a solitary papule in people aged 13-57 years, with a biphasic occurrence, usually developing on the trunk and extremities but also, rarely, on the head.
Papular xanthoma was described clinically as xanthoma, cutaneous tumour, atheroma, keloid, histiocytoma, Spitz’s nevus or clear cell acanthoma.
Histology showed moderately well circumscribed exoendophytic papules with a regular epidermis and a dense infiltration of xanthomatised macrophages interspersed by many Touton type giant cells.
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