Successful treatment of highly refractory necrobiotic xanthogranuloma with peginterferon alfa-2a.

We present an update on a 63 year old gentleman with a six year history of necrobiotic xanthogranuloma (NXG) on a background of hepatitis C.1 Additional investigations revealed trace oligoclonal gammopathy with IgG kappa and lambda. To chronicle his treatment, he presented after unsuccessful treatment with nbUVB (burns), hydroxychloroquine (ineffective) and acitretin (life-threatening side effects). In May 2014, there was mild subjective improvements with monthly 2g/kg intravenous immunoglobulin (IVIG) (over 5 days) for 4 months. In February 2015, 100mg of thalidomide daily for two months did not help.