Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Xanthomas Workup

  • Author: Kara Melissa T Torres, MD, DPDS; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Mar 25, 2015
 

Laboratory Studies

Primary hyperlipidemia is primarily a diagnosis of exclusion. Appropriate blood, urine, and radiographic workups are required to rule out a secondary cause of hyperlipidemia. Lipoprotein profiles are primarily used to assess cardiac risk and to aid in the diagnosis of lipid metabolism disorders.

Plasma levels of triglyceride, cholesterol, and HDL-cholesterol are measured following a 12-hour fast before venipuncture. Cholesterol and triglyceride levels are usually measured by enzymatic methods. HDL-cholesterol levels can be measured after the apoprotein B–containing lipoproteins (chylomicrons, VLDL, IDL, LDL, Lp[a]) are removed by polyanion-divalent cation precipitation. LDL and VLDL can then be calculated as follows:

  • LDL = Total Cholesterol Level – (Triglyceride Levels/5 + HDL Level)
  • VLDL = Triglyceride Levels/5*

*If triglycerides are greater than 700, the denominator is 10.

Chylomicrons, because of their high lipid-protein ratio, are less dense and form a creamy layer when plasma is left standing for several hours. Ultracentrifugation fractions can be electrophoretically examined for the presence of beta-VLDL and Lp(a). Quantification of apolipoproteins, particularly B and A-I, can be achieved by immunologic methods.

Lipoprotein patterns can be determined as follows:

  • I - Elevated triglyceride levels with increased chylomicron levels
  • IIa - Elevated cholesterol level because of increased LDL level
  • IIb - Elevated cholesterol and triglyceride levels because of increased LDL and VLDL levels
  • III - Elevated cholesterol and triglyceride levels, with the presence of beta-VLDL
  • IV - Elevated triglyceride levels because of increased VLDL level
  • V - Elevated triglyceride levels because of increased VLDL level and the presence of chylomicrons

The risk for cardiovascular disease can be determined on the basis of the total cholesterol, LDL-cholesterol, and HDL-cholesterol values in adults and children.

Next

Imaging Studies

Ultrasonography and magnetic resonance imaging (MRI) may enhance the diagnosis of Achilles tendon xanthomas.[71]

Positron-emission tomography/computed tomography may be used to detect disease extent and assess treatment response in cases of xanthoma disseminatum.[72]

Previous
Next

Histologic Findings

Changes in the skin and the tendons are characterized by the presence of vacuolated macrophages (foamy macrophages). These macrophages are filled with lipid droplets, which are dissolved and removed from the tissue during histologic processing. Lipid stains are of no use in routinely processed tissue. In contrast, frozen sections can be stained with lipid stains. Foamy histiocytes usually have 1 nucleus, but multinucleated histiocytes (Touton giant cells) are often identified.

See the image below.

Microscopic image of a xanthelasma. The lesion is Microscopic image of a xanthelasma. The lesion is composed of lipid-laden macrophages located in the superficial dermis. Courtesy of Duke University Medical Center.

Eruptive xanthomas may contain infiltrates of lymphocytes and typically contain extracellular lipid. Rarely, eruptive neutrophilic xanthomas with prominent leukocytoclasis may occur.[73] Xanthelasma shows superficially located foamy cells and the characteristic appearance of eyelid skin. Tendinous and tuberous xanthomas may contain prominent fibrosis and occasional cholesterol clefts. Verruciform xanthoma is histologically characterized by hyperkeratosis or parakeratosis with acanthosis, lipid-laden histiocytes within the dermal papillae, and often with a polymorphonuclear infiltrate. Red wedge-shaped areas of epidermal necrosis are characteristically present.[74] Epidermolytic acanthoma is rare but may occur.[75]

Previous
 
 
Contributor Information and Disclosures
Author

Kara Melissa T Torres, MD, DPDS Visiting Research Fellow, Ackerman Academy of Dermatopathology

Kara Melissa T Torres, MD, DPDS is a member of the following medical societies: Philippine Dermatological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Ponciano D Cruz, Jr, MD Professor and Vice-Chair, Paul R Bergstresser Chair, Department of Dermatology, University of Texas Southwestern Medical Center

Ponciano D Cruz, Jr, MD is a member of the following medical societies: Texas Medical Association

Disclosure: Received consulting fee from RCTS for independent contractor; Received honoraria from Mary Kay Cosmetics for consulting; Received grant/research funds from Galderma for principal investigator.

Acknowledgements

Kevaghn P Fair, DO Consultant Pathologist and Founder, Dominion Pathology Laboratories

Kevaghn P Fair, DO is a member of the following medical societies: American Society for Clinical Pathology, American Society of Dermatopathology, and College of American Pathologists

Disclosure: Nothing to disclose.

References
  1. Sharma D, Thirkannad S. Palmar Xanthoma-An Indicator of a More Sinister Problem. Hand (N Y). 2009 Sep 22. [Medline].

  2. Baila-Rueda L, Mateo-Gallego R, Lamiquiz-Moneo I, Cenarro A, Civeira F. Severe hypercholesterolemia and phytosterolemia with extensive xanthomas in primary biliary cirrhosis: Role of biliary excretion on sterol homeostasis. J Clin Lipidol. 2014 Sep-Oct. 8(5):520-4. [Medline].

  3. Rupec RA, Schaller M. Xanthoma disseminatum. Int J Dermatol. 2002 Dec. 41(12):911-3. [Medline].

  4. Natanzi N, Peng D, Ahdoot E, Ghatan S, Reinstandler A, Ram R. Xanthoma disseminatum in a pair of blind, deaf male twins. ISRN Dermatol. 2011. 2011:342909. [Medline]. [Full Text].

  5. Bragg J. Diffuse plane xanthomata. Dermatol Online J. 2005 Dec 30. 11(4):4. [Medline].

  6. Cumberland L, Dana A, Resh B, Fitzpatrick J, Goldenberg G. Verruciform xanthoma in the setting of cutaneous trauma and chronic inflammation: report of a patient and a brief review of the literature. J Cutan Pathol. 2010 Aug. 37(8):895-900. [Medline].

  7. Fite C, Plantier F, Dupin N, Avril MF, Moyal-Barracco M. Vulvar verruciform xanthoma: ten cases associated with lichen sclerosus, lichen planus, or other conditions. Arch Dermatol. 2011 Sep. 147(9):1087-92. [Medline].

  8. Lu S, Rohwedder A, Murphy M, Carlson JA. Verruciform xanthoma: localized lymphedema (elephantiasis) is an essential pathogenic factor. J Cutan Pathol. 2012 Mar. 39(3):391-4. [Medline].

  9. Deprez M, Uffer S. Clinicopathological features of eyelid skin tumors. A retrospective study of 5504 cases and review of literature. Am J Dermatopathol. 2009 May. 31(3):256-62. [Medline].

  10. Altman J, Winkelmann RK. Xanthoma disseminatum. Arch Dermatol. 1962. 86:582-96.

  11. Kim YR, Han KH. Familial hypercholesterolemia and the atherosclerotic disease. Korean Circ J. 2013 Jun. 43(6):363-7. [Medline]. [Full Text].

  12. Al Montasir A, Sadik MH. Acute myocardial infarction in a 28 year man with familial hypercholesterolemia. Indian J Med Sci. 2012 Mar-Apr. 66(3-4):78-81. [Medline].

  13. Ghosh SK, Majumder B, Dutta A. Tuberous xanthoma as a presenting feature of familial homozygous hypercholesterolemia with aortic regurgitation. J Pediatr. 2015 Jan. 166(1):198. [Medline].

  14. Jetha MM, Fiorillo L. Xanthomata and diabetes in an adolescent with familial dysbetalipoproteinemia 9 yr after valproate-induced pancreatitis. Pediatr Diabetes. 2012 Aug. 13(5):444-7. [Medline].

  15. Singh AP, Sikarwar S, Jatav OP, Saify K. Normolipemic tuberous xanthomas. Indian J Dermatol. 2009. 54(2):176-9. [Medline]. [Full Text].

  16. Sinnott BP, Mazzone T. Tuberous xanthomas associated with olanzapine therapy and hypertriglyceridemia in the setting of a rare apolipoprotein E mutation. Endocr Pract. 2006 Mar-Apr. 12(2):183-7. [Medline].

  17. Brown CA, Lesher JL Jr, Peterson CM. Tuberous and tendinous xanthomata secondary to ritonavir-associated hyperlipidemia. J Am Acad Dermatol. 2005 May. 52(5 Suppl 1):S86-9. [Medline].

  18. Guidry J, Thompson W, Sonabend M. Chronic myelomonocytic leukemia can present with diffuse planar xanthoma. Dermatol Online J. 2014 Jul 15. 20(7):[Medline].

  19. Emberger M, Zelger BW, Laimer M, Burgdorf W. Plaque-like papular xanthoma, an unusual, localized variant of non-Langerhans cell disease. Eur J Dermatol. 2013 Apr 1. 23(2):278-9. [Medline].

  20. Matsumoto M, Ikeda M, Takeya M, Kodama H. Plane xanthoma associated with multiple mastocytoma. Pediatr Dermatol. 2007 Sep-Oct. 24(5):E66-9. [Medline].

  21. Fujimoto N, Mieno H, Hosokawa R, Fujimoto E, Tajima S. Ultraviolet irradiation may generate plane xanthomas on mycosis fungoides. Br J Dermatol. 2013 Jan. 168(1):218-20. [Medline].

  22. Kutlubay Z, Engin B, Uzuncakmak TK, Demirkesen C, Altiti MM, Karter Y, et al. POEMS syndrome (polyneuropathy organomegaly endocrinopathy M-protein skin changes) with xanthoma - a case report. J Eur Acad Dermatol Venereol. 2014 Oct 8. [Medline].

  23. Maejima H, Katsuoka K. Sarcoidosis coexisting with eruptive xanthoma. Eur J Dermatol. 2011 Mar-Apr. 21(2):298-9. [Medline].

  24. Fett N, Teng JM. Xanthoma striatum palmare associated with nonsyndromic paucity of the interlobular bile ducts. Cutis. 2014 May. 93(5):E6-8. [Medline].

  25. Giller RH, Folberg R, Keech RV, Piette WW, Sato Y. Xanthoma disseminatum. An unusual histiocytosis syndrome. Am J Pediatr Hematol Oncol. 1988 Fall. 10(3):252-7. [Medline].

  26. Szyfter W, Wierzbicka M, Bem G. [Rare case of xanthoma disseminatum with severe dyspnoea]. Otolaryngol Pol. 2006. 60(1):67-70. [Medline].

  27. Kim JY, Jung HD, Choe YS, Lee WJ, Lee SJ, Kim do W, et al. A Case of Xanthoma Disseminatum Accentuating over the Eyelids. Ann Dermatol. 2010 Aug. 22(3):353-7. [Medline]. [Full Text].

  28. Büyükavci M, Selimoglu A, Yildirim U, Ertekin V, Atasoy M. Xanthoma disseminatum with hepatic involvement in a child. Pediatr Dermatol. 2005 Nov-Dec. 22(6):550-3. [Medline].

  29. Zak IT, Altinok D, Neilsen SS, Kish KK. Xanthoma disseminatum of the central nervous system and cranium. AJNR Am J Neuroradiol. 2006 Apr. 27(4):919-21. [Medline].

  30. Gupta P, Khandpur S, Vedi K, Singh MK, Walia R. Xanthoma disseminatum associated with inflammatory arthritis and synovitis--a rare association. Pediatr Dermatol. 2015 Jan-Feb. 32(1):e1-4. [Medline].

  31. Oka M, Oniki S, Komatsu M, Ikeda T, Matsuo M, Miyamoto Y, et al. Xanthoma disseminatum with intracranial involvement: case report and literature review. Int J Dermatol. 2010 Feb. 49(2):193-9. [Medline].

  32. Zinoun M, Hali F, Marnissi F, Lazaar S, Benchikhi H. [Xanthoma disseminatum with asymptomatic multisystem involvement.]. Ann Dermatol Venereol. 2015 Jan 24. [Medline].

  33. Ghorpade A. Xanthoma disseminatum with koebnerized pearly penile lesions in an Indian man. Int J Dermatol. 2009 Sep. 48(9):996-8. [Medline].

  34. Attia AM, Bakry OA, Mohamed EE. Xanthoma disseminatum: a progressive case with multisystem involvement. J Postgrad Med. 2014 Jan-Mar. 60(1):69-71. [Medline].

  35. Park HY, Cho DH, Kang HC, Yun SJ. A case of xanthoma disseminatum with spontaneous resolution over 10 years: review of the literature on long-term follow-up. Dermatology. 2011. 222(3):236-43. [Medline].

  36. Spanou Z, Borradori L. Diffuse plane xanthomas, a cutaneous marker for monoclonal gammopathies and lymphoproliferative diseases. Eur J Haematol. 2011 Jan. 86(1):91. [Medline].

  37. Bürgesser MV, Calafat P, Diller A. [Diffuse plane xanthomatosis associated with haematologic disorder and solid tumor. Findings of an autopsy]. Rev Fac Cien Med Univ Nac Cordoba. 2011. 68(2):65-9. [Medline].

  38. Silva DM, Chacha JJ, Wiziack Nde C, Takita LC, Hayashi FK. [Diffuse plane idiopathic normolipemic xanthoma with hypersplenism]. An Bras Dermatol. 2010 Jan-Feb. 85(1):73-6. [Medline].

  39. García-Arpa M, Rodríguez-Vázquez M, Vera E, Romero G, González-García J, Cortina P. [Normolipemic plane xanthomas and mycosis fungoides]. Actas Dermosifiliogr. 2005 Jun. 96(5):307-10. [Medline].

  40. Koçak M, Keles H, Yakaryilmaz F, Bozdogan O, Güliter S. Diffuse plane xanthomatosis in a patient with Budd-Chiari syndrome and monoclonal gammopathy. Indian J Dermatol. 2009. 54(4):369-71. [Medline]. [Full Text].

  41. Lu YT, Chen TJ, Chung WH, Kuo TT, Hong HS. Cutaneous normolipemic plane xanthoma with supraglottic involvement in a patient with hand-Schüller-Christian Disease: a case report. Am J Clin Dermatol. 2009. 10(3):189-92. [Medline].

  42. Campanati A, Goteri G, Simonetti O, Marconi B, Brandozzi G, Ganzetti G, et al. Normolipemic plane xanthomatosis with acute development preceding the clinical onset of rheumatoid arthritis. J Cutan Pathol. 2009 Oct. 36 Suppl 1:13-5. [Medline].

  43. Ko JY, Shin H, Lee CW. A verruciform xanthoma-like phenomenon in a linear epidermal naevus in the absence of a syndromic association. Br J Dermatol. 2008 Aug. 159(2):493-6. [Medline].

  44. Poulopoulos AK, Epivatianos A, Zaraboukas T, Antoniades D. Verruciform xanthoma coexisting with oral discoid lupus erythematosus. Br J Oral Maxillofac Surg. 2007 Mar. 45(2):159-60. [Medline].

  45. Gehrig RD, Baughman RA, Collins JF. Verruciform xanthoma in a young male patient with a past history of pemphigus vulgaris. Oral Surg Oral Med Oral Pathol. 1983 Jan. 55(1):58-61. [Medline].

  46. Orpin SD, Scott IC, Rajaratnam R, Colloby PS, Heagerty A. A rare case of recessive dystrophic epidermolysis bullosa and verruciform xanthoma. Clin Exp Dermatol. 2009 Jan. 34(1):49-51. [Medline].

  47. Shahrabi Farahani S, Treister NS, Khan Z, Woo SB. Oral verruciform xanthoma associated with chronic graft-versus-host disease: a report of five cases and a review of the literature. Head Neck Pathol. 2011 Jun. 5(2):193-8. [Medline]. [Full Text].

  48. Jensen JL, Liao SY, Jeffes EW 3rd. Verruciform xanthoma of the ear with coexisting epidermal dysplasia. Am J Dermatopathol. 1992 Oct. 14(5):426-30. [Medline].

  49. Mannes KD, Dekle CL, Requena L, Sangueza OP. Verruciform xanthoma associated with squamous cell carcinoma. Am J Dermatopathol. 1999 Feb. 21(1):66-9. [Medline].

  50. Xu XL, Huang LM, Wang Q, Sun JF. Multiple verruciform xanthomas in the setting of congenital hemidysplasia with ichthyosiform erythroderma and limb defects syndrome. Pediatr Dermatol. 2015 Jan-Feb. 32(1):135-7. [Medline].

  51. Yamamoto T, Katayama I, Nishioka K. Verruciform xanthoma in a psoriatic patient under PUVA therapy. Dermatology. 1995. 191(3):254-6. [Medline].

  52. Salamanca J, Alemany I, Sosa G, Pinedo F, Hernando S, Martín-Acosta P. Esophageal verruciform xanthoma following radiotherapy. Gastroenterol Hepatol. 2012 May. 35(5):317-20. [Medline].

  53. Helm KF, Höpfl RM, Kreider JW, Lookingbill DP. Verruciform xanthoma in an immunocompromised patient: a case report and immunohistochemical study. J Cutan Pathol. 1993 Feb. 20(1):84-6. [Medline].

  54. Blankenship DW, Zech L, Mirzabeigi M, Venna S. Verruciform xanthoma of the upper-extremity in the absence of chronic skin disease or syndrome: a case report and review of the literature. J Cutan Pathol. 2013 Aug. 40(8):745-52. [Medline].

  55. Pai VV, Shukla P, Bhobe M. Combined planar and eruptive xanthoma in a patient with type lla hyperlipoproteinemia. Indian J Dermatol Venereol Leprol. 2014 Sep-Oct. 80(5):467-70. [Medline].

  56. Aliasgarzadeh A, Ghorbanian M, Naghavi-Behzad M. Familial dysbetalipoproteinaemia presenting with cauliflower xanthoma. Niger Med J. 2013 Jul. 54(4):268-70. [Medline]. [Full Text].

  57. Kalidas K, Behrouz R. Inherited metabolic disorders and cerebral infarction. Expert Rev Neurother. 2008 Nov. 8(11):1731-41. [Medline].

  58. Corradino B, Di Lorenzo S, Triolo A, Moschella F. Laser treatment of giant xanthelasma palpebrarum. Lasers Med Sci. 2014 Sep 25. [Medline].

  59. Moorthy N, Ananthakrishna R, Bhat P, Nanjappa MC. Xanthoma tuberosum in homozygous familial hypercholesterolemia. Ann Pediatr Cardiol. 2014 May. 7(2):118-9. [Medline]. [Full Text].

  60. Fujiwara S, Oka M, Kunisada M, Honjo K, Nishigori C. Severe xanthomatosis with prominent tuberous xanthomas on the cheeks and the nasal dorsum in a patient with type IIa hyperlipoproteinemia. Eur J Dermatol. 2013 Jul-Aug. 23(4):517-8. [Medline].

  61. Agarwal S, Akhtar MN. Great toe gouty tophus-like lesion revealing extensive tendon xanthomatosis in a asymptomatic hyperuricemic patient. J Postgrad Med. 2013 Jul-Sep. 59(3):238-9. [Medline].

  62. Caputo R, Monti M, Berti E, Gasparini G. Normolipemic eruptive cutaneous xanthomatosis. Arch Dermatol. 1986 Nov. 122(11):1294-7. [Medline].

  63. Ansarin H, Berenji Ardestani H, Tabaie SM, Shayanfar N. Xanthoma disseminatum with tumor-like lesion on face. Case Rep Dermatol Med. 2014. 2014:621798. [Medline]. [Full Text].

  64. Hisanaga Y, Akaike Y, Kuroda K. Xanthoma disseminatum with large plaques confined to the back, pulmonary involvement and multiple intestinal xanthomas. Dermatology. 2004. 208(2):164-6. [Medline].

  65. Errichetti E, Piccirillo A, Tataranni M, Ricciuti F, Liao KL, Cheng ZL, et al. A case of diffuse plane normolipemic xanthomatosis presenting with oral lesions. G Ital Dermatol Venereol. 2014 Apr. 149(2):278-80. [Medline].

  66. Mountcastle EA, Lupton GP. Verruciform xanthomas of the digits. J Am Acad Dermatol. 1989 Feb. 20(2 Pt 2):313-7. [Medline].

  67. Kanitakis J, Euvrard S, Butnaru AC, Claudy A. Verruciform xanthoma of the scrotum in a renal transplant patient. Br J Dermatol. 2004 Jan. 150(1):161-3. [Medline].

  68. Reich O, Regauer S. Recurrent verruciform xanthoma of the vulva. Int J Gynecol Pathol. 2004 Jan. 23(1):75-7. [Medline].

  69. Griffel B, Cordoba M. Verruciform xanthoma in the anal region. Am J Proctol Gastroenterol Colon Rectal Surg. 1980 Apr. 31(4):24-5. [Medline].

  70. Becheanu G, Dumbrava M, Arbanas T, Diculescu M, Hoyeau-Idrissi N, Fléjou JF. Esophageal xanthoma--report of two new cases and review of the literature. J Gastrointestin Liver Dis. 2011 Dec. 20(4):431-3. [Medline].

  71. Fernandes EÁ, Santos EH, Tucunduva TC, Ferrari AJ, Fernandes AD. [Achilles tendon xanthoma imaging on ultrasound and magnetic resonance imaging.]. Rev Bras Reumatol. 2014 Nov 1. [Medline].

  72. Jin S, Chae SY, Chang SE, Suh C, Lee SW, Ryu JS. A case of xanthoma disseminatum: evaluation and monitoring by 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Br J Dermatol. 2014 May. 170(5):1177-81. [Medline].

  73. Aldabagh B, Bergfeld W. Eruptive neutrophilic xanthomas. Dermatol Online J. 2010 Apr 15. 16(4):6. [Medline].

  74. Shafer WG. Verruciform xanthoma. Oral Surg Oral Med Oral Pathol. 1971 Jun. 31(6):784-9. [Medline].

  75. Fukuda H, Saito R. Verruciform xanthoma in close association with isolated epidermolytic acanthoma: a case report and review of the Japanese dermatological literature. J Dermatol. 2005 Jun. 32(6):464-8. [Medline].

  76. Inazu A, Koizumi J, Kajinami K, Kiyohar T, Chichibu K, Mabuchi H. Opposite effects on serum cholesteryl ester transfer protein levels between long-term treatments with pravastatin and probucol in patients with primary hypercholesterolemia and xanthoma. Atherosclerosis. 1999 Aug. 145(2):405-13. [Medline].

  77. Fujita M, Shirai K. A comparative study of the therapeutic effect of probucol and pravastatin on xanthelasma. J Dermatol. 1996 Sep. 23(9):598-602. [Medline].

  78. Yamamoto A, Matsuzawa Y, Yokoyama S, Funahashi T, Yamamura T, Kishino B. Effects of probucol on xanthomata regression in familial hypercholesterolemia. Am J Cardiol. 1986 Jun 27. 57(16):29H-35H. [Medline].

  79. Kuo PT, Hayase K, Kostis JB, Moreyra AE. Use of combined diet and colestipol in long-term (7--7 1/2 years) treatment of patients with type II hyperlipoproteinemia. Circulation. 1979 Feb. 59(2):199-211. [Medline].

  80. Szturz P, Adam Z, Rehák Z, Koukalová R. Xanthelasma palpebrarum responding to interleukin-1 blockade. Intern Med J. 2014 Jun. 44(6):617-8. [Medline].

  81. Nakajima K, Ikeda M, Nakajima H, Kodama H. Regression of secondary plane xanthomas using cyclosporine A. Int J Dermatol. 2006 Sep. 45(9):1136-8. [Medline].

  82. Ceska R, Vrablík M, Altschmiedová T, Prusíková M, Urbanová Z, Šobra J. [Familial hypercholesterolemia - past and present. My experiences and findings in our group of patients with familial hypercholesterolemia]. Vnitr Lek. 2014 Nov. 60(11):963-9. [Medline].

  83. Khezri F, Gibson LE, Tefferi A. Xanthoma disseminatum: effective therapy with 2-chlorodeoxyadenosine in a case series. Arch Dermatol. 2011 Apr. 147(4):459-64. [Medline].

  84. Lee EH, Kang TW, Kim SC. Successful treatment of xanthoma disseminatum with simvastatin. J Dermatol. 2011 Oct. 38(10):1015-7. [Medline].

  85. Kim WJ, Ko HC, Kim BS, Kim MB. Successful treatment of xanthoma disseminatum with combined lipid lowering agents. Ann Dermatol. 2012 Aug. 24(3):380-2. [Medline]. [Full Text].

  86. Connolly SB, Lewis EJ, Lindholm JS, Zelickson BD, Zachary CB, Tope WD. Management of cutaneous verruciform xanthoma. J Am Acad Dermatol. 2000 Feb. 42(2 Pt 2):343-7. [Medline].

  87. Miyagawa F, Fukumoto T, Kobayashi N, Asada H. Successful treatment of diffuse normolipemic plane xanthoma with probucol. Case Rep Dermatol. 2013 May. 5(2):148-51. [Medline]. [Full Text].

  88. Haque MU, Ramesh V. Evaluation of three different strengths of trichloroacetic acid in xanthelasma palpebrarum. J Dermatolog Treat. 2006. 17(1):48-50. [Medline].

  89. Haygood LJ, Bennett JD, Brodell RT. Treatment of xanthelasma palpebrarum with bichloracetic acid. Dermatol Surg. 1998 Sep. 24(9):1027-31. [Medline].

  90. Lee HY, Jin US, Minn KW, Park YO. Outcomes of surgical management of xanthelasma palpebrarum. Arch Plast Surg. 2013 Jul. 40(4):380-6. [Medline]. [Full Text].

  91. Yang Y, Sun J, Xiong L, Li Q. Treatment of xanthelasma palpebrarum by upper eyelid skin flap incorporating blepharoplasty. Aesthetic Plast Surg. 2013 Oct. 37(5):882-6. [Medline].

  92. Park EJ, Youn SH, Cho EB, Lee GS, Hann SK, Kim KH, et al. Xanthelasma palpebrarum treatment with a 1,450-nm-diode laser. Dermatol Surg. 2011 Jun. 37(6):791-6. [Medline].

  93. Raulin C, Schoenermark MP, Werner S, Greve B. Xanthelasma palpebrarum: treatment with the ultrapulsed CO2 laser. Lasers Surg Med. 1999. 24(2):122-7. [Medline].

  94. Basar E, Oguz H, Ozdemir H, Ozkan S, Uslu H. Treatment of xanthelasma palpebrarum with argon laser photocoagulation. Argon laser and xanthelasma palpebrarum. Int Ophthalmol. 2004 Jan. 25(1):9-11. [Medline].

  95. Zhao Y, Wen CM, Zhou NN, Feng Q, Tu P. 1064-nm Q-switched Nd:YAG laser is an effective and safe approach to treat xanthelasma palpebrarum in Asian population. J Eur Acad Dermatol Venereol. 2014 Jun 9. [Medline].

  96. Sonthalia S, Arora R, Sarkar R. Successful cosmetic ablation of xanthelasma palpebrarum with low-voltage radiofrequency: back to the basics!. Dermatol Surg. 2014 Dec. 40(12):1443-4. [Medline].

  97. Esmat SM, Elramly AZ, Abdel Halim DM, Gawdat HI, Taha HI. Fractional CO2 laser is an effective therapeutic modality for xanthelasma palpebrarum: a randomized clinical trial. Dermatol Surg. 2014 Dec. 40(12):1349-55. [Medline].

  98. Mendelson BC, Masson JK. Xanthelasma: follow-up on results after surgical excision. Plast Reconstr Surg. 1976 Nov. 58(5):535-8. [Medline].

  99. Borelli C, Kaudewitz P. Xanthelasma palpebrarum: treatment with the erbium:YAG laser. Lasers Surg Med. 2001. 29(3):260-4. [Medline].

  100. Hsu MC, Lee CH, Chen GS, Wu CY. Nonablative 1,450-nm diode laser treatment for xanthoma disseminatum. Dermatol Surg. 2014 Dec. 40(12):1423-5. [Medline].

  101. Davies CW, Marren P, Juniper MC, Gray W, Wojnorowska F, Benson MK. Xanthoma disseminatum with respiratory tract involvement and fatal outcome. Thorax. 2000 Feb. 55(2):170-2. [Medline]. [Full Text].

 
Previous
Next
 
Xanthelasma. Courtesy of Duke University Medical Center.
Eruptive xanthomas. Courtesy of Duke University Medical Center.
Tuberous xanthomas. Courtesy of Duke University Medical Center.
Microscopic image of a xanthelasma. The lesion is composed of lipid-laden macrophages located in the superficial dermis. Courtesy of Duke University Medical Center.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.