Xanthelasma Workup

Updated: Mar 02, 2021
  • Author: Andrew A Dahl, MD, FACS; Chief Editor: Edsel B Ing, MD, PhD, MBA, MEd, MPH, MA, FRCSC  more...
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Laboratory Studies

Since more than 50% of patients with xanthelasma have lipid disorders, it is recommended that plasma lipid levels initially be obtained on all patients presenting with significant xanthelesma.  These should include LDL cholesterol and HDL cholesterol levels, triglyceride level, and apolipoprotein B100 level. Xanthelasma are usually an obvious clinical diagnosis, but, in rare cases, 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.