Xanthelasma looks like a yellow colour excess soft skin that appears over the eyelid near the nose. It is derived from ancient Greece, where “xanthos” means yellow and “elesma” means plate. Palpebrarum is a Latin word that means “near or related to the eyelid. Xanthomas are cholesterol-rich depositions that can appear anywhere in the body during various disease states. XP is a type of xanthoma that occurs over the eyelids. It is said to be associated with several medical conditions like hyperlipidemia, diabetes, and thyroid dysfunctions. It may be a predictor of ischemic heart disease, myocardial infarction, or systemic atherosclerosis. Though associated with lifestyle diseases it usually does not cause major problems. People visit surgeons because it becomes a cosmetic concern.
Epidemiology
Xanthelasma palpebrarum is an uncommon skin lesion in the general population with a crude incidence of 1.2%. It is more common in women than in men. The age of onset ranges from 20 to 70 years, but it is most commonly seen between the ages of 35 and 55 years
Pathophysiology
Xanthelasmas are the most widely recognized type of xanthoma. They are yellowish deposits composed of a cholesterol-filled substance that appear mostly over the medial aspects of the eyelids. Several medical conditions are associated with the appearance of xanthelasma, including hyperlipidemia, diabetes, and thyroid dysfunctions. It might appear in patients with normal lipid profiles, namely, cholesterol and triglyceride levels
History and Physical
These lesions are often seen in the fourth and fifth decades of life. Once xanthelasma has developed, it will not spontaneously disappear but will remain the same or increase in size. The majority of people come to attention because of cosmetic concerns. Typically, xanthelasma palpebrarum patient presents with soft, yellowish papules and plaques over the medial canthus of the upper lid. Sometimes it might be solid, semi-solid, or firm. These papules cannot be squeezed. These deposits usually will not go away on their own and typically will grow up with the time
Based on their appearance they have been divided into 4 types
- Grade I – were limited to the upper eyelid
- Grade II – involved the medial canthus,
- Grade III – affected both eyelids on the medial side, and
- Grade IV – involved both medial and lateral sides of the upper and lower eyelids
Treatment –
Medical management involves lifestyle modifications such as regular physical exercise and low-fat diet in addition to lipid-lowering drugs.
- Chemical peel like TCA. 50 %,
- CRYOTHREPAY,
- CAUTERY,
- BLADE,
- LASER
- Radiofrequency machines can be used to treat some cases of xanthelasma because it is a very safe method compared to other modalities, but it is less effective, and it might be expensive.
Disadvantages of other method-
Surgery around the eyelids is fraught with complications and can result in ectropion, eyelid retraction, and injury to the eye itself. The use of cryotherapy and chemical cauterization can lead to severe scarring and skin discoloration
Can it recur again?
Xanthelesma tends to recur if not removed completely or properly. In certain cases even after proper removal and uncontrolled cholesterol level it may recur with an interval of 12-18 months.
A note from Clinique Internationale
Your major concern right now is the xanthelesma which does not look good on your eye. Your xanthelesma is completely treatable and with the quality of service provided at Clinique Internationale, you will not have any complications later. But, what is the reason behind xanthelesma is to be treated, that is high cholesterol. It may not only prevent recurrence but, also your chances of having a heart attack and other systematic issues. We as a team wish for overall good health of our patients.