Xanthelasma Palpebrarum

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.


The medical term xanthelasma palpebrarum consists of 2 words—"xanthelasma" originates from ancient Greece and combines "xanthos," meaning yellow, with "elesma," meaning plate; palpebrarum is a Latin term indicating proximity to or association with the eyelid. Xanthelasma palpebrarum is primarily characterized by soft, lipid-rich deposits, especially cholesterol, manifesting as semisolid, yellowish papules or plaques (see Image. Xanthelasma palpebrarum). These deposits are typically found on the inner aspect of the eyes and are most commonly located along the corners of the upper and lower eyelids.

Xanthelasma palpebrarum is the most prevalent cutaneous presentation of a xanthoma that primarily occurs on the eyelids due to cholesterol deposits in the skin. Other areas of the body may or may not be affected. Although xanthelasma palpebrarum is a benign lesion and does not pose significant health risks, this condition may be a cosmetic concern due to its appearance.

Xanthomas can be associated with hyperlipidemia, diabetes, and thyroid dysfunction. Approximately 50% of adult patients with xanthelasma have abnormal lipid levels. These deposits are also prevalent in individuals with inherited dyslipidemia, such as familial hypercholesterolemia and hyperapobetalipoproteinemia. In younger individuals, particularly children, the presence of xanthelasma should prompt consideration of an underlying inherited dyslipidemia. Xanthelasma is a distinctive feature of PBC, frequently associated with significant hypercholesterolemia.

Although xanthelasma treatment is typically not medically necessary, some patients may seek therapy for cosmetic reasons. Lowering lipid levels can be beneficial in managing this condition. Treatment options include surgical excision, laser therapy, and topical trichloroacetic acid (TCA). However, it is essential to note that recurrence rates are often high. This topic delves into the etiology, pathophysiology, assessment, and treatment of individuals with xanthelasma palpebrarum. Recognizing the connection between xanthelasma and potential underlying dyslipidemia and other conditions is crucial for improving patient outcomes and reducing morbidity and mortality.

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