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Correspondence |

A Case of Adult-Onset Asthma With Periocular Xanthogranulomas

Crystal U. Agi, BA; Michael D. Gober, MD, PhD; Katalin Ferenczi, MD; Patricia Takach, MD; Ralph C. Eagle, MD; Misha Rosenbach, MD
Arch Dermatol. 2011;147(10):1230-1231. doi:10.1001/archdermatol.2011.279.
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We report a case of adult-onset asthma with periocular xanthogranuloma (AAPOX), a rare syndrome that falls into the general clinical category of periocular adult xanthogranulomatous diseases such as necrobiotic xanthogranuloma and Erdheim-Chester disease. Adult-onset asthma with periocular xanthogranuloma is a distinct entity within this group, which, to our knowledge, has not been previously described in the dermatology literature and may be an underrecognized entity.

Correspondence: Dr Rosenbach, Department of Dermatology, University of Pennsylvania, 2 Maloney Bldg, 3600 Spruce St, Philadelphia, PA 19104-4208 (misha.rosenbach@uphs.upenn.edu).

Financial Disclosure: None reported.

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Figure 1. A, Frontal view of the indurated, hyperpigmented periocular nodules infiltrating the bilateral upper and lower eyelids. B, Lateral close-up view of the infiltrative nodular plaques.

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Figure 2. Hematoxylin-eosin –stained histologic sections. A, Low-power view showing diffuse infiltrating sheets of foamy histiocytes with Touton-type giant cells in the superficial and middle dermis (arrows) and prominent lymphoid follicles (original magnification ×4). Higher-power view of areas in A denoted by arrows showing infiltrating foamy histiocytes in the dermis (B, original magnification ×10) and lymphoid follicle formation with well-formed germinal centers in the deep dermis and involving orbicularis oculi muscle (C, original magnification ×10). D, Infiltrating foamy macrophages extend into the subcutis and involve the orbicularis oculi muscle (original magnification ×40).

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