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Xanthomas is a common skin disorder, particularly among older adults and persons with elevated blood lipids (fat levels). Xanthoma is a tumour composed of lipid-filled histiocytes containing lipid material in the cytoplasm. A prominent manifestation of the hyperlipoproteinaemias is xanthomas in soft tissue, tendinous, subperiosteal and intraosseous locations. Tuberous and tendinous xanthomas produce nodular masses in soft tissue and tendons that rarely calcify; tendinous xanthomas are common in the fingers, heel, elbow and knee, at which sites they may erode subjacent bone. They are common in people of Asian extraction and those from the Mediterranean region. Xanthelasmata can be removed surgically (scarring possible), or with laser or with cryotherapy, both of which can cause scarring and pigment changes. Because of the hereditary component, they may or may not indicate high blood levels of cholesterol.
Symptoms of Xanthelasma
Xanthelasma that appear as yellowish plaques or nodules in the subcutaneous tissues in the periorbital region. They represent an accumulation of lipid-containing macrophages in the dermis. the symptoms are include :
- skin lesion or bumps under the skin ( nodules )
- With a flat surface
- Soft to the touch
- Yellow color
- Sharply defined margins (sharp, distinct borders)
Causes of Xanthelasma
Xanthomas are common skin disorders, particularly among older adults and persons with elevated blood lipids (fat levels). other causes are :
- Patients with xanthelasma are typically over 40 years of age, and women are affected nearly twice as often as men.1 The condition may be seen in light-skinned and dark-skinned individuals
- They are typically associated with an elevated cholesterol level, especially when they are seen in teenagers and young adults.
- Eruptive xanthomas can be seen in primary and secondary causes of hyperlipidemia.
- Examples of primary genetic causes include familial dyslipoproteinemia, familial hypertriglyceridemia, and familial lipoprotein lipase deficiency.
- They can appear anywhere on the body, but commonly appear on the elbows, joints, tendons, knees, hands, feet, or buttocks
- Diabetes that is out of control is a common cause of secondary hyperlipidemia. However, most xanthelasma occur in normolipemic persons who may have low HDL cholesterol levels or other lipoprotein abnormalities.
Treatment of Xanthelasma
The goal of treatment is to control underlying disorders to reduce the development of xanthelasmas and xanthomas. Treatment are :
- The growths can be surgically removed if they become bothersome, but they may reappear.
- Carbon dioxide and argon laser ablation: Enhanced hemostasis, better visualization, lack of suturing, and speed have been cited as reasons to use this technique; however, scarring and pigmentary changes can occur.
- Chemical cauterization: The use of chlorinated acetic acids has been found to be effective in the removal of xanthelasma. These agents precipitate and coagulate proteins and dissolve lipids. Monochloroacetic acid, dichloroacetic acid, and trichloroacetic acid have been used with good results. Haygood used less than .01 mL of 100% dichloroacetic acid with excellent results and minimal scarring.
- Ttreatment of xanthelasma by excision and secondary intention healing is an inexpensive, effective and safe treatment for common cosmetic problem
- Electrodesiccation and cryotherapy can destroy xanthelasmas when they are superficial but may require repeated treatments. Cryotherapy may cause scarring and hypopigmentation.
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