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Xanthelasma

Xanthelasma Palpebrarum


Presentation

  • Xanthelasma palpebrarum lesions are benign but present cosmetic problems to the patient. Their surgical removal has also presented problems to the surgeon.[ncbi.nlm.nih.gov]
  • Back to Journals » Clinical, Cosmetic and Investigational Dermatology » Volume 11 Review Video abstract presented by Pragya A Nair.[doi.org]
Pathologist
  • Erdheim–Chester disease, lipoid proteinosis ( Urbach–Wiethe disease ), and the syndrome of adult-onset asthma and periocular xanthogranuloma (AAPOX). [2] Differential diagnosis can be accomplished by surgical excision followed by microscopic examination by a pathologist[en.wikipedia.org]
Medical Laboratory Technician
  • Xanthelasmata and arcus corneae Trained nurses or medical laboratory technicians, who were unaware of the participants’ risk and disease profile, determined the presence of xanthelasmata and arcus corneae by careful visual inspection of the eyelids and[ncbi.nlm.nih.gov]
Laboratory Technician
  • Xanthelasmata and arcus corneae Trained nurses or medical laboratory technicians, who were unaware of the participants’ risk and disease profile, determined the presence of xanthelasmata and arcus corneae by careful visual inspection of the eyelids and[ncbi.nlm.nih.gov]
Weakness
  • Sometimes due to muscle paralysis or even weakness, the upper eyelid droops. Diagnosis: To confirm your diagnosis of xanthelasma, the doctor may want to perform a skin biopsy. The procedure involves: Numbing the skin with an injectable anesthetic.[medigoo.com]
Koebner Phenomenon
  • We find no report of Koebner phenomenon in xanthelasma palpebrarum in the English literature, but there are a few case reports of Koebner phenomenon in eruptive xanthoma [ 8, 9 ] and in diffuse palmar xanthoma [ 10 ].[escholarship.org]
  • Koebner phenomenon in xanthelasma after treatment with trichloroacetic acid. Dermatol Online J. 2006;12(2):12. 26. Dewan SP, Kaur A, Gupta RK. Effectiveness of cryosurgery in xanthelasma palpebrarum.[dovepress.com]
Ulcer
  • No severe complications such as infection, atrophy, ulceration, or scar were noticed. Intralesional pingyangmycin is a cheap, effective, and safe treatment for xanthelasma, which has been well accepted by patients.[ncbi.nlm.nih.gov]
  • Indurated plaques usually develop; these may appear yellow with telangiectasias, atrophy, surface ulceration, and fistulas, findings not evidenced by xanthelasma. In a series of 22 necrobiotic lesions, 21 were found in the periocular region [ 28 ].[karger.com]
Thin Skin
  • Ablation with carbon dioxide laser The advantages of this method are the accurately controlled ablation of thin skin layers, the option for a repeated application in case of recurrences, the unproblematic and safe treatment in delicate regions of the[medicaljoyworks.com]
Strabismus
  • Network); Consulting Staff, Hospital for Sick Children and Sunnybrook Hospital, Canada Edsel Ing, MD, MPH, FRCSC is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus[emedicine.medscape.com]
Lagophthalmos
  • 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.[emedicine.medscape.com]
Transient Blindness
  • The diagnostic criteria for ischaemic cerebrovascular disease were ischaemic stroke, transient ischaemic attack (focal neurological symptoms lasting less than 24 hours), or amaurosis fugax (transient blindness in one eye only).[ncbi.nlm.nih.gov]
Confusion
  • Although the clinical significance of gastric xanthelasmas is unclear, they are important lesions because they may be confused with malignant lesions.[ncbi.nlm.nih.gov]

Workup

  • At that time, the patient was referred to her primary care physician to undergo workup for dyslipidemia.[jamanetwork.com]
Hypochlorhydria
  • The patient was a 75-year-old Hispanic woman with atrophic fundic (oxyntic) gland gastritis leading to hypochlorhydria, secondary hypergastrinemia, endocrine cell hyperplasia, and multiple gastric carcinoids.[ncbi.nlm.nih.gov]
Helicobacter Pylori
  • Three patients showed associated chronic gastritis; none showed evidence of Helicobacter pylori infection.[ncbi.nlm.nih.gov]

Treatment

  • Treatment and postrecovery period were routine.In the treatment of xanthelasma palpebrarum of the lower eyelids, it is necessary to consider surgical excision as a first treatment option.[ncbi.nlm.nih.gov]
  • Other options include surgical excision, laser treatment, local application of a special acid solution and electrodesiccation (electric needle treatment).[dermapics.com]

Prognosis

  • Prognosis The condition itself is harmless. The prognosis depends on any association with underlying lipid abnormalities and cardiovascular risk.[patient.info]
  • Prognosis [ edit ] Recurrence is common: 40% of patients with XP had recurrence after primary surgical excision, 60% after secondary excision, and 80% when all four eyelids were involved.[en.wikipedia.org]
  • A diagnosis of xanthelasma palpebrarum was made, and she was counseled regarding the prognosis of the disease that the lesions do not have any chances of turning cancerous. Figure 1 (a) Yellowish plaque involving the four eyelids.[ijsronline.net]
  • Natural History, Complications, Prognosis The lesions themselves are not harmful or painful. They may, however, be a marker of underlying atherosclerosis [3].[wikidoc.org]
  • Prognosis Recurrence is common. Patients need to be aware that studies completed after surgical excision showed recurrence in up to 40% of patients. This percentage is higher with secondary excisions.[emedicine.medscape.com]

Etiology

  • Etiology Pathophysiology There is good evidence that the lipid found within xanthomas is the same lipid circulating in high concentrations in the plasma of patients. However, the exact mechanisms that induce xanthoma formation are less clear.[dermatologyadvisor.com]
  • No etiological agent could be identified. Post polypectomy, there was no recurrence or detection of carcinoma in stomach at the end of the 6-month follow up period.[tropicalgastro.com]
  • Etiology About 50% of patients who develop xanthelasma have lipid disorder.[statpearls.com]
  • Abstract: Background: Although many factors are involved in the etiology of xanthelasma palpebrum, lipid disorder is strongly associated with its induction.[scielo.br]

Epidemiology

  • A possible cause might be insufficiently deep excisions. [2] Epidemiology [ edit ] Xanthelasma is a rare disorder in the general population, with a variable incidence of 0.56–1.5% in western developed countries.[en.wikipedia.org]
  • Mette Christoffersen and Anne Tybjærg-Hansen, Visible aging signs as risk markers for ischemic heart disease: Epidemiology, pathogenesis and clinical implications, Ageing Research Reviews, 10.1016/j.arr.2015.11.002, 25, (24-41), (2016).[doi.org]
  • Keywords: eyelid • tumors • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials 2007, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved.[iovs.arvojournals.org]
  • 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[wikidoc.org]
  • Epidemiology Frequency United States Xanthelasma are not uncommon. International In India, the incidence of xanthelasma may range from 0.3%-1.5%. [1] Mortality/Morbidity These lesions have no premalignant potential; however, see Differentials.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • They represent areas of lipid-containing macrophages but the exact pathophysiology is not known. In other areas of the body the individual lesion would be called a xanthoma; xanthelasma is the most common xanthoma [ 1 ]. By Klaus D.[patient.info]
  • Clinical, cosmetic and investigational dermatology. 2018; [PubMed PMID: 29296091] [5] Zak A,Zeman M,Slaby A,Vecka M, Xanthomas: clinical and pathophysiological relations.[statpearls.com]
  • The age of onset ranges from 20 to 70 years, but it is most commonly seen between the age of 35 and 55 years. [5] [6] Pathophysiology Xanthelasmas are the most widely recognized type of xanthoma.[ncbi.nlm.nih.gov]
  • Pathophysiology Xanthelasma are a type of xanthoma appearing on the eyelids. Xanthomas are depositions of yellowish cholesterol-rich material that can appear anywhere in the body in various disease states.[emedicine.medscape.com]

Prevention

  • Although xanthelasma themselves are often asymptomatic, investigations into and treatment of any underlying cause(s) are warranted to prevent morbidity from lipid disorders and to prevent xanthelasma from progressing.[visualdx.com]
  • Having either a significant lipoprotein abnormality and/or coronary plaque identified by a heart scan should then prompt an intensified effort to prevent the heart attack that is likely in future without proper preventive action.[healthcentral.com]
  • Keywords: eyelid • tumors • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials 2007, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved.[iovs.arvojournals.org]
  • Management Patients should have their fasting lipid levels checked and those with hyperlipidaemia should have a formal cardiovascular risk assessment using appropriate charts, with measures for prevention of cardiovascular disease as indicated.[patient.info]

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