Xanthelasma

 Xanthelasma (or xanthelasma palpebrarum) is a sharply demarcated yellowish collection of cholesterol underneath the skin, usually on or around the eyelids.

What is it?

 

 

 

 ur in middle-aged and elderly patients. They appear more often in females.

Our eyelids can be affected by a variety of different clinical conditions. One such condition is called xanthalasma. Here we shall take a look at this condition in a bit more detail.

What is Xanthalasma?

Xanthalasma (Greek – ‘xanthos’ = yellow, ‘elasma’ = metal plate) is characterised by the presence of small yellow plaques that are more often visible on the upper eyelid when compared to the lower eyelid. The most common site of these yellow plaques is the inner aspect of the eyelid, sometimes referred to as the inner or medial canthus.

 

Who gets them?

General appearance

Other than the characteristic yellow colour, the lesions can be hard i.e. calcareous or soft. In the initial stages, they tend to be symmetrical with all four eyelids being involved. However, over time they might join together and become larger lesions, making it look asymmetrical.

Causes

Xanthalasma seems to bear a close relationship to high levels of lipids in the blood. In particular, they are related to the change in the structure of proteins that carry fats in the blood i.e. lipoproteins. In adds to, they are seen in certain genetic conditions such as type II and type IV hyperlipidaemia.

Clinical features

As has been described above, the lesions in xanthalasma are typically yellowish plaques that are seen on the inner aspect of the upper eyelids. They rarely cause any significant symptoms but in some cases they might cause drooping of the eyelids, also called ptosis.

Where do they Occur?

 

Are they dangerous?

Diagnosis

The characteristic appearance makes diagnosis is fairly simple to just clinical examination. Patients might undergo additional tests to check their blood cholesterol and lipid levels. If required, a biopsy might be performed for further analysis and all this will show is the presence of certain cells called histiocytes that have within them deposition of fat.

Treatment

By themselves, xanthalasma often do not cause any problems. If blood lipid levels are high, it might require treatment. If the lesions are large and are causing problems with droopy eyelids, then in some cases, surgical treatment might be offered. Additional specialist treatments such as laser ablative treatment are also available along with cryotherapy and cauterisation using chemicals.

Treatment

Prognosis

Despite the availability of surgical treatments, xanthalasma can recur in 4 out of 10 patients.