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{{Infobox_Disease |
__NOTOC__
  Name          = Xanthoma |
{{SI}}
  Image          = |
{{CMG}}; {{AE}} {{JH}}; {{VSKP}}
  Caption        = |
  DiseasesDB    = 28524 |
  ICD10          = {{ICD10|E|78|2|e|70}}, {{ICD10|K|13|4|k|00}} |
  ICD9          = {{ICD9|272.2}}, {{ICD9|374.51}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = derm |
  eMedicineTopic = 461 |
  MeshID        = D014973 |
}}
{{Search infobox}}
{{CMG}}


{{Editor Help}}
{{SK}} Xanthoma, xanthomata, xanthomatosis
== Overview == 
A '''xanthoma''' (pl. '''xanthomas''' or '''xanthomata''') (condition: '''xanthomatosis'''), from Greek ''xanthos'', '''ξανθος''', "yellow", is a deposition of yellowish [[cholesterol]]-rich material in [[tendon]]s or other body parts in various disease states.<ref name="Andrews">{{cite book |author=James, William D.; Berger, Timothy G.; et al. |title=Andrews' Diseases of the Skin: clinical Dermatology |publisher=Saunders Elsevier |location= |year=2006 |pages= |isbn=0-7216-2921-0 |oclc= |doi= |accessdate=}}</ref> They are cutaneous manifestations of [[lipidosis]] in which there is an accumulation of [[lipid]]s in large [[foam cell]]s within the skin.<ref name="Andrews"/>
[[File:Xanthoma histology.jpg|thumb|Histology picture of xanthoma showing lipid laden foam cells with large areas of cholesterol clefts, 10 × magnification, eosin and hematoxilin stain. Kumar et al. Cases Journal 2008]] They are associated with [[hyperlipidemia]]s, both primary and secondary types.


== Overview == 
Tendon Xanthoma are associated with Type II hyperlipidaemia and chronic biliary obstruction.


A '''xanthoma''' (or '''xanthomata''' or '''xanthomatosis''') (from Greek ''xanthos'', '''ξανθος''', "yellow") is a deposition of yellowish [[cholesterol]]-rich material in [[tendon]]s and other body parts in various disease states:
Palmar xanthomata and tuboeruptive xanthomata (over knees and elbows) occur in Type III hyperlipidaemia
== Causes ==
===Common causes of Xanthomas===
*[[Hypercholesterolemia]]
*[[Hyperchylomicronemia]]
*[[Hyperlipidaemia]]
*[[Hyperlipoproteinemia]]


* Tendon xanthomas (associated with [[familial hypercholesterolemia]], [[cerebrotendineous xanthomatosis]] and phytosterolemia]
===Causes by Organ System===
* Palmar xanthomas
* Eruptive xanthomas
* Tubo-eruptive xanthoma
* Xanthoma tuberosum


== Differential Diagnosis ==  
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"|  [[Hypothyroidism]], [[Myxedema]]


In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Alagille syndrome]], [[Apolipoprotein C-II deficiency]], [[Apoprotein E deficiency]], [[Cholestanol storage disease]], [[Familial hypercholesterolaemia]], [[Familial hyperlipoproteinemia type 1]], [[Familial hyperlipoproteinemia type 3]], [[Familial hypertriglyceridaemia]], [[Glycogen storage disease type I]], [[Hyperchylomicronemia]], [[Hyperlipoproteinemia]], [[Juvenile xanthogranuloma]], [[Sitosterolemia]], [[Type Ia hyperlipoproteinemia]], [[Type Ib hyperlipoproteinemia]], [[Type Ic hyperlipoproteinemia]], [[Type IIa hyperlipoproteinemia]], [[Type IIb hyperlipoproteinemia]], [[Type III hyperlipoproteinemia]], [[Type IV hyperlipoproteinemia]], [[Type V hyperlipoproteinemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"|  No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"|  No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|  No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"|  No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"|  No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Chronic pancreatitis]], [[Hypercholesterolemia]], [[Hyperlipidaemia]], [[Hypertriglyceridemia]], [[Obesity]], [[Vitamin E deficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Nephrotic syndrome]],
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Amyloidosis]], [[Primary biliary cirrhosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}


===Causes in Alphabetical Order===
{{columns-list|
*[[Alagille syndrome]]
*[[Amyloidosis]]
*[[Amyloidosis]]
*[[Biliary Cirrhosis]]
*[[Apolipoprotein C-II deficiency]]
*[[Chronic]] [[bile duct]] [[disease]]
*[[Apoprotein E deficiency]]
*[[Cholestanol storage disease]]
*[[Chronic pancreatitis]]
*[[Chronic pancreatitis]]
*[[Diabetes Mellitus]]
*[[Familial hypercholesterolaemia]]
*[[Hand-Schüller-Christian disease]]
*[[Familial hyperlipoproteinemia type 1]]
*[[Familial hyperlipoproteinemia type 3]]
*[[Familial hypertriglyceridaemia]]
*[[Glycogen storage disease type I]]
*[[Hypercholesterolemia]]
*[[Hypercholesterolemia]]
*[[Hyperchylomicronemia]]
*[[Hyperlipidaemia]]
*[[Hyperlipoproteinemia]]
*[[Hypertriglyceridemia]]
*[[Hypertriglyceridemia]]
*[[Hypothyroidism]]
*[[Juvenile xanthogranuloma]]
*[[Juvenile xanthogranuloma]]
*[[Familial hypercholesterolaemia]]
*[[Myxedema]]
*[[Myxedema]]
*[[Nephrotic Syndrome]]
*[[Nephrotic syndrome]]
*[[Urticaria pigmentosa]]
*[[Obesity]]
*[[Primary biliary cirrhosis]]
*[[Sitosterolemia]]
*[[Type Ia hyperlipoproteinemia]]
*[[Type Ib hyperlipoproteinemia]]
*[[Type Ic hyperlipoproteinemia]]
*[[Type IIa hyperlipoproteinemia]]
*[[Type IIb hyperlipoproteinemia]]
*[[Type III hyperlipoproteinemia]]
*[[Type IV hyperlipoproteinemia]]
*[[Type V hyperlipoproteinemia]]
*[[Vitamin E deficiency]]
}}


==References==
==Types==
{{Reflist|2}}
===Xanthelasma===
{{Main|Xanthelasma}}
A [[xanthelasma]] is a sharply demarcated yellowish collection of [[cholesterol]] underneath the skin, usually on or around the [[eyelids]]. Strictly, a xanthelasma is a distinct condition, only being called a xanthoma when becoming larger and nodular, assuming tumorous proportions.<ref>{{cite book |author=Shields, Carol; Shields, Jerry |title=Eyelid, conjunctival, and orbital tumors: atlas and textbook |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2008 |pages= |isbn=0-7817-7578-7 |oclc= |doi= |accessdate=}}</ref> Still, it is often classified simply as a subtype of ''xanthoma''.<ref>[http://medical-dictionary.thefreedictionary.com/xanthelasma thefreedictionary.com > xanthelasma] Citing: The American Heritage Medical Dictionary Copyright 2007, 2004 and Mosby's Medical Dictionary, 8th edition. 2009</ref>
 
===Xanthoma tuberosum===
''Xanthoma tuberosum'' is characterized by xanthomas located over the joints.


==See also==
===Xanthoma tendinosum===
* [[xanthelasma]]
''Xanthoma tendinosum'' (also known as "Tendinous xanthoma"<ref name="Bolognia">{{cite book |author=Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |pages=1415–16  |isbn=1-4160-2999-0 |oclc= |doi= |accessdate=}}</ref>) is clinically characterized by [[papule]]s and nodules found in the tendons of the hands.
* [[pseudoxanthoma elasticum]]


==External links==
===Eruptive xanthoma===
* [http://www.bidmc.org/YourHealth/ConditionsAZ.aspx?ChunkID=202823 Beth Israel Deaconess Medical Center: Xanthoma]
''Eruptive xanthoma'' ([[ILDS]] E78.220) is clinically characterized by small, yellowish-orange to reddish-brown [[papule]]s that appear all over the body.
* {{GPnotebook|194641940}}


== Acknowledgements ==
===Xanthoma planum===
The content on this page was first contributed by {{CMG}}
''Xanthoma planum'' ([[ILDS]] D76.370), also known as "Plane xanthoma", is clinically characterized by [[macule]]s and plaques spread diffusely over large areas of the body.


List of contributors:
===Palmar xanthoma===
''Palmar xanthoma'' is clinically characterized by yellowish plaques that involve the palms and flexural surfaces of the fingers. Plane xanthomas are characterised by yellowish to orange, flat macules or slightly elevated plaques, often with a central white area which may be localised or generalised. They often arise in the skin folds, especially the palmar creases. They occur in hyperlipoproteinaemia type III and type IIA, and in association with biliary cirrhosis. The presence of palmar xanthomata, like the presence of tendinous xanthomata, is indicative of hypercholesterolaemia.


== Suggested Reading and Key General References ==
===Tuberoeruptive xanthoma===
''Tuberoeruptive xanthoma'' ([[ILDS]] E78.210) is clinically characterized by red [[papule]]s and nodules that appear inflamed and tend to coalesce.  Tuberous xanthomas are considered similar, and within the same disease spectrum as tuberoeruptive xanthomas.<ref name="Bolognia">{{cite book |author=Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |pages=1414,1415 |isbn=1-4160-2999-0 |oclc= |doi= |accessdate=}}</ref>


== Suggested Links and Web Resources ==
==Differential Diagnosis of Underlying Causes of Xanthoma==  


== For Patients ==
In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>


{{Endocrine, nutritional and metabolic pathology}}
{{SIB}}
*[[Juvenile xanthogranuloma]]
{{WikiDoc Help Menu}}
*[[Nodular basal cell carcinoma ]]
{{WikiDoc Sources}}
*[[Sebaceous hyperplasia]]
*[[Syringoma]]


[[Category:Dermatology]]
==References==
[[Category:Signs and symptoms]]
{{Reflist|2}}
[[Category:Cardiology]]

Latest revision as of 23:23, 10 January 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]; Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3]

Synonyms and keywords: Xanthoma, xanthomata, xanthomatosis

Overview

A xanthoma (pl. xanthomas or xanthomata) (condition: xanthomatosis), from Greek xanthos, ξανθος, "yellow", is a deposition of yellowish cholesterol-rich material in tendons or other body parts in various disease states.[1] They are cutaneous manifestations of lipidosis in which there is an accumulation of lipids in large foam cells within the skin.[1]

File:Xanthoma histology.jpg
Histology picture of xanthoma showing lipid laden foam cells with large areas of cholesterol clefts, 10 × magnification, eosin and hematoxilin stain. Kumar et al. Cases Journal 2008

They are associated with hyperlipidemias, both primary and secondary types.

Tendon Xanthoma are associated with Type II hyperlipidaemia and chronic biliary obstruction.

Palmar xanthomata and tuboeruptive xanthomata (over knees and elbows) occur in Type III hyperlipidaemia

Causes

Common causes of Xanthomas

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine Hypothyroidism, Myxedema
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic Alagille syndrome, Apolipoprotein C-II deficiency, Apoprotein E deficiency, Cholestanol storage disease, Familial hypercholesterolaemia, Familial hyperlipoproteinemia type 1, Familial hyperlipoproteinemia type 3, Familial hypertriglyceridaemia, Glycogen storage disease type I, Hyperchylomicronemia, Hyperlipoproteinemia, Juvenile xanthogranuloma, Sitosterolemia, Type Ia hyperlipoproteinemia, Type Ib hyperlipoproteinemia, Type Ic hyperlipoproteinemia, Type IIa hyperlipoproteinemia, Type IIb hyperlipoproteinemia, Type III hyperlipoproteinemia, Type IV hyperlipoproteinemia, Type V hyperlipoproteinemia
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Chronic pancreatitis, Hypercholesterolemia, Hyperlipidaemia, Hypertriglyceridemia, Obesity, Vitamin E deficiency
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte Nephrotic syndrome,
Rheumatology/Immunology/Allergy Amyloidosis, Primary biliary cirrhosis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

Types

Xanthelasma

Main article: Xanthelasma

A xanthelasma is a sharply demarcated yellowish collection of cholesterol underneath the skin, usually on or around the eyelids. Strictly, a xanthelasma is a distinct condition, only being called a xanthoma when becoming larger and nodular, assuming tumorous proportions.[2] Still, it is often classified simply as a subtype of xanthoma.[3]

Xanthoma tuberosum

Xanthoma tuberosum is characterized by xanthomas located over the joints.

Xanthoma tendinosum

Xanthoma tendinosum (also known as "Tendinous xanthoma"[4]) is clinically characterized by papules and nodules found in the tendons of the hands.

Eruptive xanthoma

Eruptive xanthoma (ILDS E78.220) is clinically characterized by small, yellowish-orange to reddish-brown papules that appear all over the body.

Xanthoma planum

Xanthoma planum (ILDS D76.370), also known as "Plane xanthoma", is clinically characterized by macules and plaques spread diffusely over large areas of the body.

Palmar xanthoma

Palmar xanthoma is clinically characterized by yellowish plaques that involve the palms and flexural surfaces of the fingers. Plane xanthomas are characterised by yellowish to orange, flat macules or slightly elevated plaques, often with a central white area which may be localised or generalised. They often arise in the skin folds, especially the palmar creases. They occur in hyperlipoproteinaemia type III and type IIA, and in association with biliary cirrhosis. The presence of palmar xanthomata, like the presence of tendinous xanthomata, is indicative of hypercholesterolaemia.

Tuberoeruptive xanthoma

Tuberoeruptive xanthoma (ILDS E78.210) is clinically characterized by red papules and nodules that appear inflamed and tend to coalesce. Tuberous xanthomas are considered similar, and within the same disease spectrum as tuberoeruptive xanthomas.[4]

Differential Diagnosis of Underlying Causes of Xanthoma

In alphabetical order. [5] [6]


References

  1. ↑ 1.0 1.1 James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
  2. ↑ Shields, Carol; Shields, Jerry (2008). Eyelid, conjunctival, and orbital tumors: atlas and textbook. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7578-7.
  3. ↑ thefreedictionary.com > xanthelasma Citing: The American Heritage Medical Dictionary Copyright 2007, 2004 and Mosby's Medical Dictionary, 8th edition. 2009
  4. ↑ 4.0 4.1 Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 1415–16. ISBN 1-4160-2999-0.
  5. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  6. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
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