Today we’re going to discuss about Xanthelasma.

We all have heard about high cholesterol levels in the blood, in many people. But when there is deposition of cholesterol in the skin, this condition is called Xanthelasma.

Most commonly, it is manifested as deposition of yellow tissues in the upper layer of the skin of the eyelids. But in severe cases, this deposition can occur all around the area of the eye.

WHEN DOES IT OCCUR ?

Xanthelasma is usually seen to occur in people over 40 to 50 years of age.

However, in families where either of the parents are having this condition, the children can get this condition much earlier in life.

WHY DOES IT OCCUR ?

There is no documentation or study as of yet, of the definite cause of this condition.

However, it is usually seen in people with high levels of blood cholesterol.

But in 50% cases, the patient is seen to have normal levels of blood cholesterol and in those cases, the cause of occurrence of this condition is not known.

It can occur as a side effect of taking various medicines, for example steroids, cyclosporine, retinoid, and medicines for HIV etc. and there are many such medications, which increase the blood cholesterol level of the patient, which can cause Xanthelasma.

SYMPTOMS

Xanthelasma has no painful symptoms, neither does it cause irritation or itching of the affected area.

The only thing that the patient may face is cosmetic problem. Since it looks bad over the skin, people may tend to avoid social gatherings and it may lower their self confidence. For this reason, people suffering with this condition tend to seek treatment.

DIAGNOSIS

The diagnosis can easily be done through clinical examination and can be done by the patient only.

However, there are some other diseases which present similar symptoms and can be confused with Xanthelasma. For example :-

Syringoma
Necrobiotic Xanthogranuloma

In such cases, other tests are done to confirm the diagnosis.

TREATMENT

There are many available methods of treatment. However no treatment guarantees to be fully effective and there are always chances of recurrence.

The available methods of treatment are :-

Surgery – It involves surgical removal of the tissues where there is deposition of cholesterol. This remains effective for 3 to 4 years, but there are still chances of recurrence after that.
Chemical cautery – This is done with 50 to 70 % Trichloroacetic acid. When applied over the affected area, frosting occurs and the skin peels off in 8 to 10 days and new skin comes in its place. This remains effective for 6 to 7 months and recurrence can occur as well.

However, this process has to done under strict supervision of a dermatologist as it is a very sensitive procedure, and if not done properly can damage your eye.

Electrocautery & Radiofrequency cautery – In which the affected tissue is burned by application of heat
LASER treatment – There are many options available for laser treatment such as Nd:YAG, Er:YAG etc.

*One should keep in mind whatever the method of treatment is, there is always a chance of recurrence. Therefore, it is recommended not to opt for expensive treatment methods such as laser, but instead cheaper methods are available such as chemical cautery, which can be easily repeated in case of recurrences.

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Blog by: Dr. Uttam Kumar Lenka, Consultant Dermatologist. Kolkata.