DDx
Diagnostic Considerations
Familial hypercholesterolemia types IIa and IIb
Familial dysbetalipoproteinemia type III
Familial hypertriglyceridemia type IV
Other lipid disorders, to include the following:
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Low HDL cholesterol levels as compared to low-density lipoprotein (LDL) levels
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Diabetes, uncontrolled with associated hypertriglyceridemia
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Necrobiotic xanthogranuloma
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Tuberous xanthomata
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Diffuse planar xanthoma
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Orbital lipogranulomata
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Juvenile xanthogranulomata
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Erdheim-Chester disease
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Wegener granulomatosis
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Lipoid proteinosis
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Primary systemic amyloidosis
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Necrobiosis lipoidica
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Sarcoid
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Atypical lymphoid infiltrate
Pseudoxanthelasma - One case history describes retinal surgery with silicone oil in tissue mimicking xanthelasma. [3]
Differential Diagnoses
Media Gallery
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Case presentation of excision of recurrent xanthelasma. Recurrent xanthelasma bilateral upper lids; previous excision combined with blepharoplasty; patient insistent on repeat excision and blepharoplasty; advised of lagophthalmos risk due to medial position and lack of medial dermatochalasis.
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Close-up view of recurrent xanthelasma right upper lid. Note the scar from previous excision by a plastic surgeon. Careful examination reveals subtle infiltration in the lateral aspect of scar.
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Xanthelasma. External view, 1 week after surgery. Sliding and rotational flaps from residual lateral dermatochalasis used for medial excisional gap.
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Xanthelasma. Top image, 4 weeks after surgery; lower image, before surgery.
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Xanthelesma of four eyelids in patient with hyperlipidemia.
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