By Gary M. White, MD

Xanthoma Disseminatum Courtesy Department of Dermatology, University of California, Irvine

Xanthoma disseminatum (XD), also known as Montgomery syndrome, is a rare, benign, mucocutaneous xanthomatosis which represents a non-Langerhans cell histiocytosis.


Xanthoma disseminatum presents as orange to red to mahogany-brown papules and nodules symmetric in both axilla and on the flanks typically in a young adult. Lesions are symmetric and the preferred sites of involvement in decreasing order are axilla, eyelids, groin, neck, trunk, and face. Perianal tumors may interfere with defecation.


This disease is benign but the course is chronic. Most therapies fail. Although the lipid profile is normal, clofibrate has been used with partial success. Oral corticosteroids and antimitotic drugs may be tried but usually fail.  Cyclophosphamide was beneficial in one patient. Multiple cycles of cladribine and arabinoside (Ara-C) were successful in another patient [British J Dermatology 2014 May]. In another case report, a patient was treated with a combination of rosiglitazone 4 mg daily, simvastatin 10 mg daily, and fenofibrate 200 mg daily treatment. Within a year, his lesions improved 50% [Ann Dermatol. 2012 Aug;24(3):380-382].

Additional Pictures

Courtesy Department of Dermatology, University of California, Irvine
Xanthoma Disseminatum


A 62-year-old man presented with skin changes on the face, flexors, and trunk for 30 years. Exam showed hundreds of red to brown papules were distributed symmetrically on axilla, genitalia, poplitea, trunk and nasal mucosa. Case Reports in Dermatologic Medicine

A 37-year-old Asian male presented with 5-year history of numerous asymptomatic yellow-brownish papules distributed on face and flexural areas. His lipid levels were normal. He also had diabetes insipidus. Ann Dermatol. 2012 Aug;24(3):380-382


Homepage | FAQs | Contact Dr. White

It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegionalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegionalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.