Plexiform Xanthoma
Jonathan B. McHugh, MD
Key Facts
Clinical Issues
Rare
Tend to occur in young adults (4th decade)
Most often occur in extremities
Elbow and knee regions most frequent
Dermal-based cutaneous nodule
May or may not have dyslipidemia
Local recurrences do occur with inadequate excision
Microscopic Pathology
Nodular and plexiform proliferation of foamy macrophages located within dermis
Top Differential Diagnoses
Plexiform xanthomatous tumor
Schwannoma (plexiform)
Lipidized benign fibrous histiocytoma
Plexiform fibrohistiocytic tumor
Tuberous and tendinous xanthoma
 A multinodular proliferation with a plexiform architecture filling the dermis is typical of plexiform xanthoma. The deep nodules  tend to be more well developed than the superficial ones. |
 Medium-power view shows the typical appearance of plexiform xanthoma, with variably sized nodules arranged in a plexiform configuration and with associated fibrosis  . |
TERMINOLOGY
Definitions
Superficial (dermis/subcutis) nodular proliferation of lipid-laden macrophages with plexiform arrangement
CLINICAL ISSUES
Epidemiology
Incidence
Rare
Only single case reports and small series in the literature
Age
Tend to occur in young adults (4th decade)
Gender
Men affected more frequently than women
Site
Most often occur in extremities
Tend to occur on extensor surfaces
Elbow and knee region most frequent subsites
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