A New Approach for Extensive Upper and Lower Lid Xanthogranuloma with Positive Touton Giant Cells
Author: Hala Ali
Base Hospital / Institution: King Fahd Hospital of the University (KFHU), Khobar, Saudi Arabia; Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia.
ePoster presentation
Abstract ID: 24-279
Purpose
This study aims to help identify xanthogranuloma presentations, associated systemic disease, and options for treatment. In this case, a 45-year-old male known for dyslipidemia and mild hypertension presented with extensive bilateral periocular xanthogranuloma slowly progressing over 10 years. The lesions were resistant to steroid injections and bleomycin, and, on biopsy, were positive for Touton giant cells. There were no other systemic complaints or findings. Amongst the available therapies, we highlight the usage of a plasma pen as a novel method for treating this condition.
Methods
Due to the extensive and irregular distribution of the lesions, traditional full-thickness excision and skin grafting was not feasible in all affected areas. Thus, a plasma pen was utilized for the medium- and small-sized xanthogranulomatous lesions. The patient underwent 2 procedures, 1 year apart, involving partial excision of the lesions to achieve a 1.5 mm thickness. After achieving hemostasis, a plasma pen was applied to the lesion bed with an acupuncture tip until homogenous ablation was attained. The patient was then followed up in the clinic for further monitoring.
Results
A 12-month and 3-month follow-up after the first and second procedures, respectively, showed effective cosmetic and functional improvement, minimal recurrence, and no notable complications.
Conclusion
To our knowledge, this is the first reported case of periocular xanthogranuloma treated with plasma pen ablation, a non-invasive therapy that stimulates skin regeneration. This offers a promising new approach in the management of extensive periocular and primary simple xanthogranuloma. Further research is encouraged to validate these findings.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Basheer | AlDajani | King Fahd Hospital of the University (KFHU), Khobar, Saudi Arabia; Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia. |
| Mohammed | Alismail | King Fahd Hospital of the University (KFHU), Khobar, Saudi Arabia; Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia. |
| Hissah | AlTurki | King Fahd Hospital of the University (KFHU), Khobar, Saudi Arabia; Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia. |
