XANTHELASMA
XANTHELASMA ICD-10: H02.6
• Most common of all xanthomas. In most cases, an isolated finding unrelated to hyperlipidemia.
• Occurs in individuals >50 years; however, when in children or young adults, it is associated with familial hypercholesterolemia (FH) or familial dysbetalipoproteinemia (FD).
• Skin lesions are asymptomatic. Soft, polygonal yellow-orange papules and plaques localized to upper and lower eyelids (Fig. 15-9) and around inner canthus. Slow enlargement from tiny spots over months to years.
• Cholesterol should be estimated in plasma; if enhanced, screening for type of hyperlipidemia (FH or FD). If resulting from hyperlipidemia, complication with atherosclerotic cardiovascular disease may be expected.
• Laser, excision, electrodesiccation, or topical application of trichloroacetic acid. Recurrences are not uncommon.
• Synonyms: Xanthelasma palpebrarum, periocular xanthoma.
FIGURE 15-9 • Xanthelasma Multiple creamy-orange, slightly elevated dermal papules on the eyelids of a normolipemic individual.