Surgery as an option in adult onset Xanthogranuloma

Adult orbital xanthogranulomatous disease (AOXGD) is a group of rare syndromes, involving the periorbital and ocular tissues. We present details of a case of adult-onset xanthogranuloma (AOX) and the management strategy employed in a positive outcome. AOX is the least common variant of AOXGD without any significant systemic involvement. The significance of this entity is that it is often self-limited and is localised to the eye (anterior orbit), with good prognosis. We have kept surgery as our viable primary option in patients presenting late with functional problems and severe cosmetic deformity. In cases with disfiguring lesions and late presentation, the best therapeutic approach is complete excision biopsy and reconstruction with local flaps and full-thickness skin graft. Level of Evidence: Level V, Case report.