Xanthelasma is a sharply demarcated yellowish deposit of cholesterol underneath the skin.[1] It usually occurs on or around the eyelids (xanthelasma palpebrarum, abbreviated XP).[1][2] While they are neither harmful to the skin nor painful, these minor growths may be disfiguring and can be removed.[1] There is a growing body of evidence for the association between xanthelasma deposits and blood low-density lipoprotein levels and increased risk of atherosclerosis.[3][4]
| Xanthelasma | |
|---|---|
| Other names | xanthelasma palpebrarum; xanthoma palpebrarum |
 | |
| Pronunciation | |
| Specialty | Ophthalmology  |
A xanthelasma may be referred to as a xanthoma when becoming larger and nodular, assuming tumorous proportions.[5] Xanthelasma is often classified simply as a subtype of xanthoma.[6]
Diagnosis
editXanthelasma in the form of XP can be diagnosed from clinical impression, although in some cases it may need to be distinguished (differential diagnosis) from other conditions, especially necrobiotic xanthogranuloma, syringoma, palpebral sarcoidosis, sebaceous hyperplasia, Erdheim–Chester disease, lipoid proteinosis (Urbach–Wiethe disease), and the syndrome of adult-onset asthma and periocular xanthogranuloma (AAPOX).[2] Differential diagnosis can be accomplished by surgical excision followed by microscopic examination by a pathologist (biopsy to determine histopathology).[2] The typical clinical impression of XP is soft, yellowish papules, plaques, or nodules, symmetrically distributed on the medial side of the upper eyelids; sometimes the lower eyelids are affected as well.[2]
Treatment
editXanthelasmata can be removed with a trichloroacetic acid peel, surgery, lasers or cryotherapy.[2] Removal may cause, although uncommon, scarring and pigment changes.
Prognosis
editRecurrence is common: 40% of patients with XP had recurrence after primary surgical excision, 60% after secondary excision, and 80% when all four eyelids were involved. A possible cause might be insufficiently deep excisions.[2]
Epidemiology
editXanthelasma is a rare disorder in the general population, with a variable incidence of 0.56 to 1.5% in western developed countries. The age of onset ranges from 15 to 75, with a peak in the 4th to 5th decades of life. There also seems to be a greater prevalence in females, but this might be due to higher consciousness to cosmetic defects.[7]
Etymology
editThe word is derived from Greek xanthós, ξανθός 'yellow' and élasma, έλασμα, 'foil'. The plural is xanthelasmata.
See also
edit- Xanthoma, a similar collection of cholesterol around tendons
- List of xanthoma variants associated with hyperlipoproteinemia subtypes
References
edit- ^ a b c Frew JW, Murrell DF, Haber RM (October 2015). "Fifty shades of yellow: a review of the xanthodermatoses". International Journal of Dermatology. 54 (10): 1109–1123. doi:10.1111/ijd.12945. PMID 26227781.
- ^ a b c d e f Nair PA, Singhal R (2017-12-18). "Xanthelasma palpebrarum - a brief review". Clinical, Cosmetic and Investigational Dermatology. 11: 1–5. doi:10.2147/CCID.S130116. PMC 5739544. PMID 29296091.
- ^ Ozdöl S, Sahin S, Tokgözoğlu L (August 2008). "Xanthelasma palpebrarum and its relation to atherosclerotic risk factors and lipoprotein (a)". International Journal of Dermatology. 47 (8): 785–9. doi:10.1111/j.1365-4632.2008.03690.x. PMID 18717856. S2CID 25746456.
- ^ Chang, Hua-Ching; Sung, Chih-Wei; Lin, Ming-Hsiu (March 2020). "Serum lipids and risk of atherosclerosis in xanthelasma palpebrarum: A systematic review and meta-analysis". Journal of the American Academy of Dermatology. 82 (3): 596–605. doi:10.1016/j.jaad.2019.08.082. PMID 31499151. S2CID 202413378.
- ^ Shields C, Shields J (2008). Eyelid, conjunctival and orbital tumors: atlas and textbook. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 978-0-7817-7578-6.[page needed]
- ^
Xanthelasma (8th ed.). 2009. Retrieved November 8, 2012.
{{cite book}}:|work=ignored (help) - ^ Jain A, Goyal P, Nigam PK, Gurbaksh H, Sharma RC (September 2007). "Xanthelasma Palpebrarum-clinical and biochemical profile in a tertiary care hospital of Delhi". Indian Journal of Clinical Biochemistry. 22 (2): 151–3. doi:10.1007/BF02913335. PMC 3453794. PMID 23105704.