Successful Treatment of Diffuse Normolipemic Plane Xanthoma with Probucol
A 70-year-old woman presented with well-defined macular yellowish patches on her eyelids, both cheeks, and the nose lasting over a few years (fig. ). She had no history of topical steroid use or extensive sun exposure on her face. Her medical history was unremarkable. A skin biopsy specimen revealed the accumulation of foam cells and Touton giant cells in the superficial dermis (fig. ). These cells were CD68 positive, and CD1a and S-100 negative. Complete blood count, and liver and renal function tests were within normal limits, but she had elevated levels of IgA [460.7 mg/dl (normal values: 100–400 mg/dl)] and amylase [270 IU/l (normal values: 40–120 IU/l)]. No M protein was noted. Plasma lipid levels including total cholesterol, HDL and LDL cholesterols, triglycerides, and apolipoproteins were normal. Chest X-ray and abdominal ultrasonography were also normal. She was diagnosed with idiopathic macroamylasemia and treatment was considered unnecessary. Based on the clinical and histopathological findings, a diagnosis of DNPX was made and oral administration of probucol (500 mg/day) was initiated. The lesions began to recede after 2 weeks and had almost resolved within 8 months (fig. ).