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  • Xanthelasma and Xanthoma

    Definition

    Xanthoma is a condition in which fatty deposits form beneath the skin. They can be more than three inches in size or very small. Xanthomas are not painful or dangerous, but can be cosmetically disfiguring. Xanthomas may appear anywhere on the body, but are most frequently found on the elbows, joints, tendons, knees, hands, feet, and buttocks.
    Xanthelasma is a form of xanthoma that appears on the eyelids.

    Causes

    Xanthoma is typically caused by:
    • Elevated levels of lipids (fats) in the blood
    • Metabolic disorders including:
      • Diabetes
      • Primary biliary cirrhosis
      • Some cancers
      • Inherited metabolic disorders like familial hypercholesterolemia (high levels of cholesterol in the blood)
    Although xantlelasma may be associated with high triglyceride and cholesterol levels it can occur without cholesterol problems.

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition.
    The following factors increase your chance of developing xanthoma:
    • Having a metabolic disorder listed above
    • Having extremely high cholesterol and/or triglyceride levels
    • Aging

    Symptoms

    The most common symptoms of xanthoma are:
    • Bumps under the skin
    • Skin lesions that are:
      • Many different shapes
      • Yellow to orange
      • Have well-defined borders

    Diagnosis

    Xanthoma is usually diagnosed by examining the skin growths, but a biopsy of the tissue will confirm a fatty deposit.
    Skin Biopsy
    Skin proceedure
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    A blood lipid profile and other tests may be done to determine the underlying condition responsible for the appearance of xanthomas.

    Treatment

    Treating xanthoma consists of treating and controlling the underlying health conditions that cause the fatty deposits to develop. Better control of the metabolic disorders that can lead to xanthoma can reduce their occurrence.
    Xanthomas may be tender, itchy, and painful. Xanthomas can recur after treatment.
    Other treatment options for xanthomas include:

    Surgery

    Surgery may be used to remove the fatty deposits. However, even after a xanthoma is surgically removed, it can recur.

    Laser

    Laser surgery with CO2 laser, pulse-dye laser, or Erbium-YAG laser can be performed.

    Chemical

    Treatment with trichloroacetic acid may also be used to treat xanthomas.

    Prevention

    To help reduce your chances of getting xanthoma, take the following steps:
    • Keep blood lipids and cholesterol at a healthy level
    • Keep metabolic disorders well-controlled

    RESOURCES

    American Academy of Dermatology http://www.aad.org

    American Academy of Family Physicians http://familydoctor.org

    CANADIAN RESOURCES

    British Columbia Ministry of Health http://www.bchealthguide.org

    Canadian Dermatology Association http://www.dermatology.ca/

    References

    Ellis K, Sprecher D. Hyperlipidemia. The Cleveland Clinic website. Published May 29, 2002. Available at: http://www.clevelandclinicmeded.com/diseasemanagement/cardiology/hyperlipidemia/hyperlipidemia.htm. Accessed April 15, 2007.

    Encyclopedia: xanthelasma and xanthoma. The University of Tennessee Medical Center website. Available at: http://www.utmedicalcenter.org/encyclopedia/?file=001447trt.htm. Accessed April 15, 2007.

    Feingold K, Castro G, Ishikawa Y, Fielding P, Fielding C. Cutaneous xanthoma in association with paraproteinemia in the absence of hyperlipidemia. J Clin Invest . 1989 Mar;83(3):796-802.

    Revision Information

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