eMedicine Specialties > Ophthalmology > Lid
Xanthelasma: Differential Diagnoses & Workup
Updated: Dec 3, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Other Problems to Be Considered
Familial hypercholesterolemia types IIa and IIbFamilial dysbetalipoproteinemia type III
Familial hypertriglyceridemia type IV
Other lipid disorders, to include the following:
- Low HDL cholesterol levels as compared to low-density lipoprotein (LDL) levels
- Diabetes, uncontrolled with associated hypertriglyceridemia
- Necrobiotic xanthogranuloma
- Tuberous xanthomata
- Diffuse planar xanthoma
- Orbital lipogranulomata
- Juvenile xanthogranulomata
- Erdheim-Chester disease
- Wegener granulomatosis
- Lipoid proteinosis
- Primary systemic amyloidosis
- Necrobiosis lipoidica
- Sarcoid
- Atypical lymphoid infiltrate
Workup
Laboratory Studies
- Since 50% of patients with xanthelasma have lipid disorders, it is recommended that their plasma lipid levels are obtained, as well as LDL cholesterol and HDL cholesterol levels.
- Xanthelasma usually is an obvious clinical diagnosis but rarely other lesions can simulate the appearance and may be associated with disorders of a more serious nature. If there is any doubt, surgical excision and pathologic analysis should be performed.
Histologic Findings
Xanthelasma are composed of xanthoma cells. These are foamy histiocytes laden with intracellular fat deposits primarily within the upper reticular dermis. The main lipid that is stored in hyperlipidemic and normolipidemic xanthelasmas is cholesterol. Most of this cholesterol is esterified.
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Differential Diagnoses & Workup: Xanthelasma |
| Treatment & Medication: Xanthelasma |
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References
Doi H, Ogawa Y. A new operative method for treatment of xanthelasma or xanthoma palpebrarum: microsurgical inverted peeling. Plast Reconstr Surg. Sep 1998;102(4):1171-4. [Medline].
Haygood LJ, Bennett JD, Brodell RT. Treatment of xanthelasma palpebrarum with bichloracetic acid. Dermatol Surg. Sep 1998;24(9):1027-31. [Medline].
Basar E, Oguz H, Ozdemir H, et al. Treatment of xanthelasma palpebrarum with argon laser photocoagulation. Argon laser and xanthelasma palpebrarum. Int Ophthalmol. Jan 2004;25(1):9-11. [Medline].
Bergman R. Xanthelasma palpebrarum and risk of atherosclerosis. Int J Dermatol. May 1998;37(5):343-5. [Medline].
Egan CA, Patel BC, Morschbacher R, et al. Atypical lymphoid hyperplasia of the eyelids manifesting as xanthelasma-like lesions. J Am Acad Dermatol. Nov 1997;37(5 Pt 2):839-42. [Medline].
Gladstone, Geoffrey, Myint, Shoib. Xanthelasma. In: Roy FH and Fraunfelder FT, eds. Current Ocular Therapy. Vol. 5. 2000:452-3.
Howard GR. Xanthelasma. In: Roy FH, ed. Masters Technique in Ophthalmic Surgery. 1995:520-2.
Ozdol S, Sahin S, Tokgozoglu L. Xanthelasma palpebrarum and its relation to atherosclerotic risk factors and lipoprotein (a). Int J Dermatol. Aug 2008;47(8):785-9. [Medline].
Usatine RP. A cutaneous manifestation of a systemic disease. West J Med. Feb 2000;172(2):84. [Medline].
Ustunsoy E, Demir Z, Coskunfirat K, et al. Extensive bilateral eyelid ptosis caused by xanthoma palpebrarum. Ann Plast Surg. Feb 1997;38(2):177-8. [Medline].
Further Reading
Keywords
xanthelasma, xanthelasma palpebrarum, xanthoma, cutaneous xanthoma, xanthomatosis
Differential Diagnoses & Workup: Xanthelasma