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{{Infobox_Disease
__NOTOC__
| Name          = Xanthelasma
{{CMG}}; {{AE}} {{JH}}.
| Image          = Xanthelasma.jpg
{{SK}}: Xanthelasma palpebrarum.
| Caption        =
| DiseasesDB    = 28519
| ICD10          = {{ICD10|H|02|6|h|00}}
| ICD9          = {{ICD9|374.51}}
| ICDO          =
| OMIM          =
| MedlinePlus    = 001447
| eMedicineSubj  = oph
| eMedicineTopic = 610
| MeshID        =
}}


{{Search infobox}}
==Overview==
'''Xanthelasma''' (or '''xanthelasma palpebrarum''') is a sharply demarcated yellowish collection of [[cholesterol]] underneath the skin, usually on or around the [[eyelids]]. The plural is "xanthelasmata". The root of the word is from Greek xanthos, ξανθος, "yellow".
 
Xanthelasma are distinct from [[xanthoma]] which are larger and nodular, lesions.<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> Xanthelasma are sometimes classified 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>
 
==Epidemiology and Demographics==
A study of 12,745 people from Denmark identified xanthelasmata in 4.4% of participants aged 20-93.
 
==Natural History, Complications, Prognosis==
The lesions themselves are not harmful or painful.  They may, however, be a marker of underlying [[atherosclerosis]]<ref>Christofferson et al. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort studyBMJ 2011; 343:d5497</ref>.
 
===Association with Atherosclerosis===
In a prospective population based cohort study (The Copenhagen City Heart Study), a total of 12,745 participants who were free of ischemic heart disease and aged 20-93 years were followed for a mean of 22 years <ref>Christofferson et al. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort studyBMJ 2011; 343:d5497</ref>.  The mulivariate adjusted risk (hazard/odds ratios adjusted for confounders including [[cholesterol]] and [[triglyceride]] concentrations) of an adverse outcome associated with the presence of xanthelasmata were as follows:
 
*[[Myocardial infarction]]: 1.48 (95% confidence interval 1.23 to 1.79)
*[[Ischemic stroke]]: 0.94 (0.73 to 1.21)
* Death: 1.14 (1.04 to 1.26) for death.
 
Thus, independent of other [[cardiac risk factors]], the presence of a xanthelasma appers to be an independent risk factor for [[atherosclerotic heart disease]]. In the same study, [[arcus senilis]] was not identified as an independent risk factor<ref>BMJ 2011; 343:d5497</ref>.
 
===Gallery===
 
====Head====
 
<gallery>


{{CMG}}
Image: Xeroderma_pigmentosum_01.png| Xeroderma pigmentosum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=500>


{{Editor Help}}
Image: Xeroderma_pigmentosum_02.png| Xeroderma pigmentosum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=500>


==Overview==
Image: Xeroderma_pigmentosum_04.png| Xeroderma pigmentosum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=500>
'''Xanthelasma''' (or '''xanthelasma palpebrarum''') is a sharply demarcated yellowish collection of [[cholesterol]] underneath the skin, usually on or around the [[eyelids]]. Although not harmful or painful, these minor growths may be disfiguring and can be removed. The plural is "xanthelasmata". They are common in people of Asian extraction and those from the Mediterranean region. Xanthelasmata can be removed with [[trichloroacetic acid]] peel, surgery, lasers or [[cryotherapy]]. Removal can cause scarring and pigment changes, but it is unusual after treatment with trichloroacetic acid. Because of the hereditary component, they may or may not indicate high blood levels of [[cholesterol]]. Where there is no family history of xanthelasmata they usually indicate high cholesterol and may correlate with a risk of atheromatous disease (cholesterol building up in arteries). The root of the word is from Greek xanthos, ξανθος, "yellow".
 
</gallery>
 
====Extremities====
 
<gallery>


==Associations==
Image: Xeroderma_pigmentosum_05.jpeg| Xeroderma pigmentosum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=500>
* [[Hypercholesterolemia|High cholesterol levels]] (specifically [[familial hypercholesterolemia]])
* [[Primary biliary cirrhosis]]
* [[Menopause]]
* [[Diabetes]]


==See also==
</gallery>
* [[Xanthoma]] (similar collections of cholesterol around tendons)


==External links==
====Trunk====
* {{MedlinePlus|001447|Xanthelasma and Xanthoma}}


==References==
<gallery>
* Lang, Gerhard K ''Ophthalmology'' Thieme. Stuttgart. 2000.


{{SIB}}
Image: Xeroderma_pigmentosum_03.jpeg| Xeroderma pigmentosum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=500>
{{Eye pathology}}
{{Symptoms and signs}}


[[da:Xantelasma]]
</gallery>
[[de:Xanthelasma]]
[[es:Xantelasma]]
[[fr:Xanthelasma]]
[[nl:Xanthelasma]]
[[pt:Xantelasma]]
[[sv:Xantelasma]]
[[pl:Kępki żółte]]
[[tr:Ksantelasma]]


==Differential Diagnosis of Associated Conditions==
* [[Diabetes]]
* [[Hypercholesterolemia|High cholesterol levels]] (specifically [[familial hypercholesterolemia]])
* [[LDL receptor deficiency]]
* [[Menopause]]
* [[Primary biliary cirrhosis]]
*[[Vitamin E deficiency]] (familial isolated, [[autosomal recessive]] inheritance)


==Treatment==
These minor growths may be disfiguring and can be removed.  Xanthelasmata can be removed with [[trichloroacetic acid]] peel, surgery, lasers or [[cryotherapy]]. Removal can cause scarring and pigment changes, but it is unusual after treatment with trichloroacetic acid.


[[Category:Human appearance]]
==See also==
[[Category:Ophthalmology]]
* [[Xanthoma]] (similar collections of cholesterol around tendons)
[[Category:Dermatology]]
[[Category:Medical signs]]
[[Category:Hepatology]]
[[Category:Gastroenterology]]
[[Category:Signs and symptoms]]
[[Category:Ddx]]


{{WH}}
==References==
{{WikiDoc Sources}}
{{Reflist|2}}

Latest revision as of 15:04, 20 December 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]. Synonyms and keywords:: Xanthelasma palpebrarum.

Overview

Xanthelasma (or xanthelasma palpebrarum) is a sharply demarcated yellowish collection of cholesterol underneath the skin, usually on or around the eyelids. The plural is "xanthelasmata". The root of the word is from Greek xanthos, ξανθος, "yellow".

Xanthelasma are distinct from xanthoma which are larger and nodular, lesions.[1] Xanthelasma are sometimes classified as a subtype of xanthoma.[2]

Epidemiology and Demographics

A study of 12,745 people from Denmark identified xanthelasmata in 4.4% of participants aged 20-93.

Natural History, Complications, Prognosis

The lesions themselves are not harmful or painful. They may, however, be a marker of underlying atherosclerosis[3].

Association with Atherosclerosis

In a prospective population based cohort study (The Copenhagen City Heart Study), a total of 12,745 participants who were free of ischemic heart disease and aged 20-93 years were followed for a mean of 22 years [4]. The mulivariate adjusted risk (hazard/odds ratios adjusted for confounders including cholesterol and triglyceride concentrations) of an adverse outcome associated with the presence of xanthelasmata were as follows:

Thus, independent of other cardiac risk factors, the presence of a xanthelasma appers to be an independent risk factor for atherosclerotic heart disease. In the same study, arcus senilis was not identified as an independent risk factor[5].

Gallery

Head

Extremities

Trunk

Differential Diagnosis of Associated Conditions

Treatment

These minor growths may be disfiguring and can be removed. Xanthelasmata can be removed with trichloroacetic acid peel, surgery, lasers or cryotherapy. Removal can cause scarring and pigment changes, but it is unusual after treatment with trichloroacetic acid.

See also

  • Xanthoma (similar collections of cholesterol around tendons)

References

  1. ↑ Shields, Carol; Shields, Jerry (2008). Eyelid, conjunctival, and orbital tumors: atlas and textbook. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7578-7.
  2. ↑ thefreedictionary.com > xanthelasma Citing: The American Heritage Medical Dictionary Copyright 2007, 2004 and Mosby's Medical Dictionary, 8th edition. 2009
  3. ↑ Christofferson et al. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort studyBMJ 2011; 343:d5497
  4. ↑ Christofferson et al. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort studyBMJ 2011; 343:d5497
  5. ↑ BMJ 2011; 343:d5497
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