Xanthelasma is also known as xanthelasma palpebrarum. It is a sharply demarcated yellowish swelling underneath the skin. It is usually seen on or around the eyelids. It is basically a collection of fat. They do not produce any harm or affect the eye or skin. However it may produce a cosmetic impediment to the person suffering. Their size may vary. In some cases they might be very tiny. In others they might be quite large and appear disfiguring. It is commonly seen among people of Asian origin and among those from the Mediterranean region. It bears a strong hereditary component which means if one of the parents are prone to develop Xanthelasmas then the offspring too might develop it sooner or later during their lifetime. In most cases it bears a strong correlation the lipid levels in one’s body. Those who are obese and have high levels of blood cholesterol are more prone to develop Xanthelasmas as against those who do not have high blood cholesterol levels or a family history. It is considered to be a subtype of xanthoma.
Risk factors for developing Xanthelasmas: It is associated with high blood lipids – high blood cholesterol and triglycerides, LDL etc., though this may not be a necessary finding. Certain other medical conditions may be associated with it like familial hypercholesterolemia, primary biliary cirrhosis, diabetes and certain malignancies. Also a strong family history of Xanthelasmas among parents, sibling’s etc raises the chances of developing it during one’s lifetime.
It can be differentiated from the xanthoma based on physical findings. A xanthoma looks like a bump under the skin. It will vary in size and may be seen anywhere on the body. It is most commonly seen over the tendons and bones. It is usually flat and soft to touch. It is mostly yellow in colour. It usually has sharp and distinct edges.
Diagnostic Tests: It is mainly a clinical finding and diagnosis can be confirmed on mere inspection. A xanthoma on the other hand may require biopsy in some cases, in order to show fatty deposition on biopsy. Further tests like blood lipid levels is of most importance, liver function tests and blood glucose levels may be done. Also the characteristic of xanthelasmas on the eyelids are diagnostic and main differentiating criteria between xanthelasma and xanthoma.
Treatment of Xanthelasmas: Control of blood lipids is important. Any other underlying causes too must be detected and treated accordingly. Tight control of blood lipids may help check the development of new Xanthelasmas and may cause resorption of the existing ones. In cases where it affects the patient due to cosmetic reasons, surgical intervention may be used.
Chemical cauterization: This includes the use of chlorinated acetic acids and is effective in removal of xanthelasma. Other acids like trichloroacetic, dichloroacetic acids too are useful for the procedure.
Carbon dioxide and argon laser ablation is also used for removal of xanthelasmas.
Electrodessication and cryotherapy are other known methods of treatment, especially when the xanthelasmas are superficial. Cryotherapy usually has the side effect of scarring of the skin and hypopigmentation after usage.
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