Xanthelasma

Xanthelasma is a sharply delimited yellowish collection of cholesterol underneath the skin, usually on or around the eyelids. Xanthelasma palpebrarum is the most common cutaneous xanthoma. Xanthelasma is caused by pintsize deposits of fat in the skin and is often associated with abnormal blood fat levels (hyperlipidemia). Though not harmful or painful, these minor growths may be disfiguring and can be removed surgically. Xanthelasmata can be removed surgically (scarring likely), or with laser or with cryotherapy, both of which can cause scarring and pigment changes.

Where there is no family history of xanthelasmata they frequently indicate high cholesterol and may link with a chanace of atheromatous disease (cholesterol building up in arteries). The term is emanated from the Greek xanthos (yellow) and elasma (beaten metal plate). Frequently, they are symmetrical; often 4 lids are involved. Xanthelasma have a tendency to headway, coalesce, and become permanent.

Xanthelasma is a freakish disorder of the skin. They may represent a generalized cutaneous phenomenon without systemic abnormalities of lipoprotein metabolism or an increase in the cholesterol-rich beta-lipoproteins (LDL). Commonly multiple and often symmetrical in dispersion, lesions can occur in normolipemic individuals.

Nonetheless, they are of considerable value in identifying hyperlipemic patients at risk for occlusive vascular disease. Patients having xanthelasma should have a lipid profile determination. It can arise at any age, but it is more frequently seen in adults over the age of fifty.  Basically it appears as yellow-orange plaques on the eyelids.

Causes of Xanthelasma

The common Causes of Xanthelasma :

• Patients having xanthelasma are typically over 40 years of age, and women are infected nearly twice as often as men. The condition may be seen in light-skinned and dark-skinned individuals
• Eruptive xanthomas can be seen in primary and secondary causes of hyperlipidemia.
• They can appear anywhere on the body, but frequently appear on the elbows, joints, tendons, knees, hands, feet, or buttocks
• Instances of primary genetic causes include familial dyslipoproteinemia, familial hypertriglyceridemia, and familial lipoprotein lipase deficiency.
• Diabetes which is out of control is a common cause of secondary hyperlipidemia. Nevertheless, most xanthelasma occur in normolipemic persons who may have low HDL cholesterol levels or other lipoprotein abnormalities.

Symptoms of Xanthelasma

Some Symptoms of Xanthelasma :

• Soft to the touch
• With a flat surface
• Skin lesion or bumps under the skin ( nodules )
• Yellow color
• Flat surface
• Sharply defined margins (sharp, distinct borders)

Treatment of Xanthelasma

• The development can be surgically removed if they become nettlesome, but they may reappear.
• Ttreatment of xanthelasma by excision and secondary objective healing is an inexpensive, effective and safe treatment for common cosmetic problem
• Enhanced hemostasis, better visualization, lack of suturing, and speed have been adduced as reasons to use this technique; however, scarring and pigmentary changes can occur.
• The use of chlorinated acetic acids has been found to be efficacious in the removal of xanthelasma. These agents precipitate and gelatinize proteins and dissolve lipids. Monochloroacetic acid, dichloroacetic acid, and trichloroacetic acid have been used with better results. Haygood used less than .01 mL of 100% dichloroacetic acid with superb results and minimal scarring.
• Electrodesiccation and cryotherapy can shatter xanthelasmas when they are superficial but may need repeated treatments. Cryotherapy may cause scarring and hypopigmentation.

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