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Periorbital xanthogranuloma after blepharoplasty
  1. Christopher I Zoumalan1,
  2. Melanie H Erb2,
  3. Narsing A Rao2,
  4. Robert See2,
  5. Michael A Bernstine2,
  6. Samir B Shah3,
  7. Timothy J McCulley3
  1. 1Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
  2. 2University of Southern California, Doheny Eye Institute, Los Angeles, California, USA
  3. 3Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to: Dr T J McCulley Department of Ophthalmology, University of California San Francisco, 10 Koret Way, San Francisco, CA 94143-0336, USA; mcculleyt{at}vision.ucsf.edu

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Periocular xanthogranuloma is a rare inflammatory condition characterised by histiocytes and Touton giant cells. It is encountered in several settings: juvenile xanthogranuloma, Erdheim–Chester disease (ECD) and necrobiotic xanthogranuloma. Recently, cases with an adult onset not associated with ECD have been described, with frequent involvement of the eyelids and orbit.1–3 In this report, we describe a unique case of adult-onset periocular xanthogranuloma precipitated by blepharoplasty.

Case report

A 57-year-old woman was referred for persistent postoperative oedema/inflammation 18 months after bilateral upper and lower blepharoplasty. On the basis of a review of her medical record and a conversation with her cosmetic surgeon, there was no suggestion of disease before surgery: her periocular involutional changes were typical and no abnormalities were noted intraoperatively. Her …

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