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Case Reports
. 2024 Jun 11;16(6):e62168.
doi: 10.7759/cureus.62168. eCollection 2024 Jun.

Cladribine Use in Xanthoma Disseminatum: A Rare Case Presentation and Brief Updated Literature Review

Matthew M Gayed  1 , Olivia S Jew  1 , Rami N Al-Rohil  2 , Meenal Kheterpal  1
Affiliations
Case Reports

Cladribine Use in Xanthoma Disseminatum: A Rare Case Presentation and Brief Updated Literature Review

Matthew M Gayed et al. Cureus. .

Abstract

Xanthoma disseminatum (XD) is a rare, non-Langerhans cell histiocytosis. While treatment is notoriously difficult, 2-chlorodeoxyadenosine (cladribine) has recently emerged as a potential effective therapeutic option. Here, we describe the case of a 65-year-old male with XD who experienced significant cutaneous improvement after cladribine treatment. We also provide an updated literature review on cladribine use in patients with XD in light of reported adverse effects (AEs). While the efficacy of cladribine in XD is clear, no consensus exists for treatment duration and AE management. Hence, we strongly encourage interdisciplinary discourse involving dermatology and oncology in these cases.

Keywords: adverse effects; cladribine; non-langerhans cell histiocytosis; oncology; therapeutics.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Clinical images of xanthoma disseminatum before and after cladribine
Physical exam revealed reddish-brown papular lesions coalescing into plaques prior to the initiation of cladribine on the back (A) and right upper extremity (B). After six cycles of cladribine therapy, lesions on the back (C) and right upper extremity (D) exhibited flattening, reduced induration, and reduced erythema.
Figure 2
Figure 2. Histological images of xanthoma disseminatum
Hematoxylin and eosin of skin punch biopsy reveals papillary and mid-dermal infiltrate (A, 4×). The infiltrate is composed of xanthomatous cells admixed with some lymphocytes with background dermal fibrosis (B, 10×). Among the xanthomatous cells, numerous Touton giant cells were observed (C, 40×).
See this image and copyright information in PMC

References

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