Xanthomas
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Xanthomas are lesions characterized by accumulations of lipid-laden macrophages. Xanthomas can develop in the setting of altered systemic lipid metabolism or as a result of local cell dysfunction.
Lipids are insoluble in water; therefore, they are transported as complexes of lipoproteins and specific apoproteins. These proteins also serve as ligands to specific receptors, they facilitate transmembrane transport, and they regulate enzymatic activity. Lipoproteins may be classified according to their density, as follows: chylomicrons, very-low-density lipoproteins (VLDL), intermediate-density lipoproteins (IDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL).
The metabolic pathways of lipoproteins can be divided into exogenous and endogenous pathways. The exogenous lipoprotein pathway refers to the metabolism of intestinal lipoproteins, the triglyceride-rich chylomicrons, primarily formed in response to dietary fat. The endogenous lipoprotein pathway refers to lipoproteins and apoproteins that are synthesized in tissues other than the intestines, predominantly in the liver. The liver secretes the triglyceride-rich VLDL that contains apoproteins B-100, C-II, and E into the circulation.
In the peripheral tissues, particularly adipose and muscle tissue, VLDL is cleaved by lipoprotein lipase (LPL), extracting most of the triglycerides and forming an IDL that contains apoproteins B-100 and E. IDL can be taken up by the liver through the LDL receptor, or it can be converted to the cholesterol-rich LDL that contains apoprotein B-100. LDL is removed from the circulation primarily by the liver through the LDL receptor. HDL particles that contain apoproteins A-I and A-II interact with other lipoproteins, particularly VLDL and LDL, through lipolysis and the action of lecithin cholesterol acyltransferase (LCAT) enzyme. The main role of HDL is to accept cholesterol and to transport it back to the liver (reverse cholesterol transport).
Lipoprotein (a) (Lp[a]) consists of an LDL-like particle with apoprotein B and a side chain of a highly glycosylated protein. Lp(a) has a role not only in atherogenesis but also in thrombogenesis because of its homology with plasminogen.
Alterations in lipoproteins result either from genetic mutations that yield defective apolipoproteins (primary hyperlipoproteinemia) or from some other underlying systemic disorder, such as diabetes mellitus, hypothyroidism, or nephrotic syndrome (secondary hyperlipoproteinemia). The biochemical and genetic basis for the inherited disorders of lipid and lipoprotein metabolism differ considerably.
Traditionally, hyperlipidemias have been classified according to 6 phenotypes described by Fredrickson. These phenotypes are based on the electrophoretic patterns of lipoprotein level elevations that occur in patients with hyperlipoproteinemia. In recent years, the understanding of the genetic and biochemical basis of these disorders has revealed a large and diverse group of diseases, many of which have similar clinical expressions, exposing the limitations of the Fredrickson classification system. Despite the system’s shortcomings, Fredrickson phenotypes are a useful tool for the discussion of these disorders. The understanding of the pathophysiology of these defects provides a basis for diagnosis and treatment.
Familial lipoprotein lipase deficiency is an example of a primary disorder in which a deficiency of lipoprotein lipase in tissue leads to a type I pattern of hyperlipidemia, with a massive accumulation of chylomicrons in the plasma. This effect results in a severe elevation of plasma triglyceride levels. Plasma cholesterol levels are not usually elevated. Patients with type I may present in early childhood, often with acute pancreatitis. Eruptive xanthomas are the most characteristic skin manifestation of this disorder.
Cholesterol is bound to apolipoprotein B-100 as LDL in interstitial fluid. Cells may acquire cholesterol via an LDL receptor on the cell membrane. Familial LDL receptor deficiency and familial defective apoprotein B-100 are examples of primary defects that can lead to the accumulation of LDL, which corresponds to a type IIa pattern of hyperlipidemia. Plasma cholesterol levels are severely elevated, but plasma triglyceride levels are typically normal. Patients with type IIa have severe atherosclerosis.
The type IIb pattern is characterized by the accumulation of both LDL and VLDL, with variable elevations of both triglyceride levels and cholesterol levels in the plasma. Patients with familial combined hyperlipoproteinemia have such a pattern of hyperlipidemia, but a specific genetic defect has not been established.
Patients with type IIa and IIb may present as adults with tendinous and tuberous xanthomas and xanthelasmas.
Type III hyperlipidemia is characterized by the accumulation of IDL (beta-VLDL), which is manifested by increases in both triglyceride levels and cholesterol levels in the plasma. A genetic basis for the primary disorder, familial dysbetalipoproteinemia, has been well established. Various mutations of apoprotein E impair its ability to bind to the IDL receptor. Patients with type III present as adults with premature atherosclerosis and, particularly, plane (palmar) xanthomas. [1]
Familial hypertriglyceridemia is an example of a primary defect resulting in type IV hyperlipidemia. Accumulation of VLDL causes severe elevations of plasma triglyceride levels. Plasma cholesterol levels are typically normal. A definitive molecular defect has not been established. Patients with type IV may present with eruptive xanthomas.
Genetic defects of the apolipoprotein C-II gene result in the accumulation of chylomicrons and VLDL, which is the type V pattern of hyperlipidemia. Patients with this type have severe elevations of triglyceride levels in the plasma. These patients, like those with lipoprotein lipase deficiency, may present in early childhood with acute pancreatitis and eruptive xanthomas. [2]
Decreased synthesis of HDL due to decreased formation of apoprotein A-I and apoprotein C-III leads to decreased reversed cholesterol transport, resulting in increased LDL levels, premature coronary artery disease, and plane xanthomas.
Hyperlipidemia is also related to a variety of secondary causes. Secondary hypercholesterolemia can be found in pregnancy, hypothyroidism, cholestasis, and acute intermittent porphyria. Secondary hypertriglyceridemia can be associated with oral contraceptive use, diabetes mellitus, alcoholism, pancreatitis, gout, sepsis due to gram-negative bacterial organisms, and type I glycogen storage disease. Combined hypercholesterolemia and hypertriglyceridemia can be found in nephrotic syndrome, chronic renal failure, and steroid immunosuppressive therapy. [3, 4]
Normolipemic xanthoma may occur as xanthoma disseminatum, diffuse plane normolipemic xanthomatosis, and verruciform xanthoma.
Xanthoma disseminatum is a non–Langerhans cell of class II histiocytic disorder. [5] The etiology is unknown. Familial inheritance is uncertain. [6]
Diffuse plane xanthomatosis is a rare, noninherited disorder related to diseases of the reticuloendothelial system. [7] The pathogenesis remains unclear.
Verruciform xanthoma is considered a reaction pattern to chronic inflammation or trauma or a result of impaired lymphatic function. [8, 9, 10]
Xanthomas are a common manifestation of lipid metabolism disorders. Xanthelasmas comprise 6% of eyelid tumors. [11] Diffuse normolipemic forms occur less frequently.
Equal prevalence of xanthoma is reported in males and females. Xanthoma disseminatum occurs in a male-to-female ratio of 2.4:1. [12]
Xanthomas may occur in persons of any age. Xanthelasmas usually occur in people older than 50 years. Xanthoma disseminatum occurs before age 25 years in two thirds of cases. [12]
Cutaneous xanthomas are mostly cosmetic disorders; their presence might suggest an underlying disorder of lipid metabolism.
Recurrences postsurgical treatment of xanthomas are common.
Significant mortality and morbidity arise in patients with involvement of functional anatomic sites in xanthoma disseminatum. [13] Otherwise, the course of the disease is benign and resolves spontaneously. [14]
Morbidity and mortality are related to atherosclerosis (eg, coronary artery disease) and pancreatitis.
For patient education resources, visit the Cholesterol Center. Also, see the patient education articles High Cholesterol, Cholesterol FAQs, and Atorvastatin (Lipitor).
Sharma D, Thirkannad S. Palmar Xanthoma-An Indicator of a More Sinister Problem. Hand (N Y). 2009 Sep 22. [Medline].
Duzayak S, Sayiner ZA, Erkılıç S, Inaloz HS. Acute pancreatitis with eruptive xanthoma. BMJ Case Rep. 2017 Oct 9. 2017:[Medline].
Baila-Rueda L, Mateo-Gallego R, Lamiquiz-Moneo I, Cenarro A, Civeira F. Severe hypercholesterolemia and phytosterolemia with extensive xanthomas in primary biliary cirrhosis: Role of biliary excretion on sterol homeostasis. J Clin Lipidol. 2014 Sep-Oct. 8(5):520-4. [Medline].
Taylor B, Cheema A, Soslowsky L. Tendon Pathology in Hypercholesterolemia and Familial Hypercholesterolemia. Curr Rheumatol Rep. 2017 Nov 4. 19 (12):76. [Medline].
Rupec RA, Schaller M. Xanthoma disseminatum. Int J Dermatol. 2002 Dec. 41(12):911-3. [Medline].
Natanzi N, Peng D, Ahdoot E, Ghatan S, Reinstandler A, Ram R. Xanthoma disseminatum in a pair of blind, deaf male twins. ISRN Dermatol. 2011. 2011:342909. [Medline]. [Full Text].
Bragg J. Diffuse plane xanthomata. Dermatol Online J. 2005 Dec 30. 11(4):4. [Medline].
Cumberland L, Dana A, Resh B, Fitzpatrick J, Goldenberg G. Verruciform xanthoma in the setting of cutaneous trauma and chronic inflammation: report of a patient and a brief review of the literature. J Cutan Pathol. 2010 Aug. 37(8):895-900. [Medline].
Fite C, Plantier F, Dupin N, Avril MF, Moyal-Barracco M. Vulvar verruciform xanthoma: ten cases associated with lichen sclerosus, lichen planus, or other conditions. Arch Dermatol. 2011 Sep. 147(9):1087-92. [Medline].
Lu S, Rohwedder A, Murphy M, Carlson JA. Verruciform xanthoma: localized lymphedema (elephantiasis) is an essential pathogenic factor. J Cutan Pathol. 2012 Mar. 39(3):391-4. [Medline].
Deprez M, Uffer S. Clinicopathological features of eyelid skin tumors. A retrospective study of 5504 cases and review of literature. Am J Dermatopathol. 2009 May. 31(3):256-62. [Medline].
Altman J, Winkelmann RK. Xanthoma disseminatum. Arch Dermatol. 1962. 86:582-96.
Davies CW, Marren P, Juniper MC, Gray W, Wojnorowska F, Benson MK. Xanthoma disseminatum with respiratory tract involvement and fatal outcome. Thorax. 2000 Feb. 55(2):170-2. [Medline]. [Full Text].
Park HY, Cho DH, Kang HC, Yun SJ. A case of xanthoma disseminatum with spontaneous resolution over 10 years: review of the literature on long-term follow-up. Dermatology. 2011. 222(3):236-43. [Medline].
Kim YR, Han KH. Familial hypercholesterolemia and the atherosclerotic disease. Korean Circ J. 2013 Jun. 43(6):363-7. [Medline]. [Full Text].
Al Montasir A, Sadik MH. Acute myocardial infarction in a 28 year man with familial hypercholesterolemia. Indian J Med Sci. 2012 Mar-Apr. 66(3-4):78-81. [Medline].
Ghosh SK, Majumder B, Dutta A. Tuberous xanthoma as a presenting feature of familial homozygous hypercholesterolemia with aortic regurgitation. J Pediatr. 2015 Jan. 166(1):198. [Medline].
Jetha MM, Fiorillo L. Xanthomata and diabetes in an adolescent with familial dysbetalipoproteinemia 9 yr after valproate-induced pancreatitis. Pediatr Diabetes. 2012 Aug. 13(5):444-7. [Medline].
Singh AP, Sikarwar S, Jatav OP, Saify K. Normolipemic tuberous xanthomas. Indian J Dermatol. 2009. 54(2):176-9. [Medline]. [Full Text].
Sinnott BP, Mazzone T. Tuberous xanthomas associated with olanzapine therapy and hypertriglyceridemia in the setting of a rare apolipoprotein E mutation. Endocr Pract. 2006 Mar-Apr. 12(2):183-7. [Medline].
Brown CA, Lesher JL Jr, Peterson CM. Tuberous and tendinous xanthomata secondary to ritonavir-associated hyperlipidemia. J Am Acad Dermatol. 2005 May. 52(5 Suppl 1):S86-9. [Medline].
Guidry J, Thompson W, Sonabend M. Chronic myelomonocytic leukemia can present with diffuse planar xanthoma. Dermatol Online J. 2014 Jul 15. 20(7):[Medline].
Emberger M, Zelger BW, Laimer M, Burgdorf W. Plaque-like papular xanthoma, an unusual, localized variant of non-Langerhans cell disease. Eur J Dermatol. 2013 Apr 1. 23(2):278-9. [Medline].
Matsumoto M, Ikeda M, Takeya M, Kodama H. Plane xanthoma associated with multiple mastocytoma. Pediatr Dermatol. 2007 Sep-Oct. 24(5):E66-9. [Medline].
Fujimoto N, Mieno H, Hosokawa R, Fujimoto E, Tajima S. Ultraviolet irradiation may generate plane xanthomas on mycosis fungoides. Br J Dermatol. 2013 Jan. 168(1):218-20. [Medline].
Kutlubay Z, Engin B, Uzuncakmak TK, Demirkesen C, Altiti MM, Karter Y, et al. POEMS syndrome (polyneuropathy organomegaly endocrinopathy M-protein skin changes) with xanthoma – a case report. J Eur Acad Dermatol Venereol. 2014 Oct 8. [Medline].
Maejima H, Katsuoka K. Sarcoidosis coexisting with eruptive xanthoma. Eur J Dermatol. 2011 Mar-Apr. 21(2):298-9. [Medline].
Fett N, Teng JM. Xanthoma striatum palmare associated with nonsyndromic paucity of the interlobular bile ducts. Cutis. 2014 May. 93(5):E6-8. [Medline].
Pearson HJ, Mosser JL, Jacks SK. The triad of pruritus, xanthomas, and cholestasis: Two cases and a brief review of the literature. Pediatr Dermatol. 2017 Nov. 34 (6):e305-e308. [Medline].
Giller RH, Folberg R, Keech RV, Piette WW, Sato Y. Xanthoma disseminatum. An unusual histiocytosis syndrome. Am J Pediatr Hematol Oncol. 1988 Fall. 10(3):252-7. [Medline].
Szyfter W, Wierzbicka M, Bem G. [Rare case of xanthoma disseminatum with severe dyspnoea]. Otolaryngol Pol. 2006. 60(1):67-70. [Medline].
Kim JY, Jung HD, Choe YS, Lee WJ, Lee SJ, Kim do W, et al. A Case of Xanthoma Disseminatum Accentuating over the Eyelids. Ann Dermatol. 2010 Aug. 22(3):353-7. [Medline]. [Full Text].
Büyükavci M, Selimoglu A, Yildirim U, Ertekin V, Atasoy M. Xanthoma disseminatum with hepatic involvement in a child. Pediatr Dermatol. 2005 Nov-Dec. 22(6):550-3. [Medline].
Zak IT, Altinok D, Neilsen SS, Kish KK. Xanthoma disseminatum of the central nervous system and cranium. AJNR Am J Neuroradiol. 2006 Apr. 27(4):919-21. [Medline].
Gupta P, Khandpur S, Vedi K, Singh MK, Walia R. Xanthoma disseminatum associated with inflammatory arthritis and synovitis–a rare association. Pediatr Dermatol. 2015 Jan-Feb. 32(1):e1-4. [Medline].
Oka M, Oniki S, Komatsu M, Ikeda T, Matsuo M, Miyamoto Y, et al. Xanthoma disseminatum with intracranial involvement: case report and literature review. Int J Dermatol. 2010 Feb. 49(2):193-9. [Medline].
Zinoun M, Hali F, Marnissi F, Lazaar S, Benchikhi H. [Xanthoma disseminatum with asymptomatic multisystem involvement.]. Ann Dermatol Venereol. 2015 Jan 24. [Medline].
Ghorpade A. Xanthoma disseminatum with koebnerized pearly penile lesions in an Indian man. Int J Dermatol. 2009 Sep. 48(9):996-8. [Medline].
Attia AM, Bakry OA, Mohamed EE. Xanthoma disseminatum: a progressive case with multisystem involvement. J Postgrad Med. 2014 Jan-Mar. 60(1):69-71. [Medline].
Spanou Z, Borradori L. Diffuse plane xanthomas, a cutaneous marker for monoclonal gammopathies and lymphoproliferative diseases. Eur J Haematol. 2011 Jan. 86(1):91. [Medline].
Bürgesser MV, Calafat P, Diller A. [Diffuse plane xanthomatosis associated with haematologic disorder and solid tumor. Findings of an autopsy]. Rev Fac Cien Med Univ Nac Cordoba. 2011. 68(2):65-9. [Medline].
Silva DM, Chacha JJ, Wiziack Nde C, Takita LC, Hayashi FK. [Diffuse plane idiopathic normolipemic xanthoma with hypersplenism]. An Bras Dermatol. 2010 Jan-Feb. 85(1):73-6. [Medline].
García-Arpa M, Rodríguez-Vázquez M, Vera E, Romero G, González-García J, Cortina P. [Normolipemic plane xanthomas and mycosis fungoides]. Actas Dermosifiliogr. 2005 Jun. 96(5):307-10. [Medline].
Koçak M, Keles H, Yakaryilmaz F, Bozdogan O, Güliter S. Diffuse plane xanthomatosis in a patient with Budd-Chiari syndrome and monoclonal gammopathy. Indian J Dermatol. 2009. 54(4):369-71. [Medline]. [Full Text].
Lu YT, Chen TJ, Chung WH, Kuo TT, Hong HS. Cutaneous normolipemic plane xanthoma with supraglottic involvement in a patient with hand-Schüller-Christian Disease: a case report. Am J Clin Dermatol. 2009. 10(3):189-92. [Medline].
Campanati A, Goteri G, Simonetti O, Marconi B, Brandozzi G, Ganzetti G, et al. Normolipemic plane xanthomatosis with acute development preceding the clinical onset of rheumatoid arthritis. J Cutan Pathol. 2009 Oct. 36 Suppl 1:13-5. [Medline].
Ko JY, Shin H, Lee CW. A verruciform xanthoma-like phenomenon in a linear epidermal naevus in the absence of a syndromic association. Br J Dermatol. 2008 Aug. 159(2):493-6. [Medline].
Poulopoulos AK, Epivatianos A, Zaraboukas T, Antoniades D. Verruciform xanthoma coexisting with oral discoid lupus erythematosus. Br J Oral Maxillofac Surg. 2007 Mar. 45(2):159-60. [Medline].
Gehrig RD, Baughman RA, Collins JF. Verruciform xanthoma in a young male patient with a past history of pemphigus vulgaris. Oral Surg Oral Med Oral Pathol. 1983 Jan. 55(1):58-61. [Medline].
Orpin SD, Scott IC, Rajaratnam R, Colloby PS, Heagerty A. A rare case of recessive dystrophic epidermolysis bullosa and verruciform xanthoma. Clin Exp Dermatol. 2009 Jan. 34(1):49-51. [Medline].
Shahrabi Farahani S, Treister NS, Khan Z, Woo SB. Oral verruciform xanthoma associated with chronic graft-versus-host disease: a report of five cases and a review of the literature. Head Neck Pathol. 2011 Jun. 5(2):193-8. [Medline]. [Full Text].
Jensen JL, Liao SY, Jeffes EW 3rd. Verruciform xanthoma of the ear with coexisting epidermal dysplasia. Am J Dermatopathol. 1992 Oct. 14(5):426-30. [Medline].
Mannes KD, Dekle CL, Requena L, Sangueza OP. Verruciform xanthoma associated with squamous cell carcinoma. Am J Dermatopathol. 1999 Feb. 21(1):66-9. [Medline].
Xu XL, Huang LM, Wang Q, Sun JF. Multiple verruciform xanthomas in the setting of congenital hemidysplasia with ichthyosiform erythroderma and limb defects syndrome. Pediatr Dermatol. 2015 Jan-Feb. 32(1):135-7. [Medline].
Yamamoto T, Katayama I, Nishioka K. Verruciform xanthoma in a psoriatic patient under PUVA therapy. Dermatology. 1995. 191(3):254-6. [Medline].
Salamanca J, Alemany I, Sosa G, Pinedo F, Hernando S, Martín-Acosta P. Esophageal verruciform xanthoma following radiotherapy. Gastroenterol Hepatol. 2012 May. 35(5):317-20. [Medline].
Helm KF, Höpfl RM, Kreider JW, Lookingbill DP. Verruciform xanthoma in an immunocompromised patient: a case report and immunohistochemical study. J Cutan Pathol. 1993 Feb. 20(1):84-6. [Medline].
Blankenship DW, Zech L, Mirzabeigi M, Venna S. Verruciform xanthoma of the upper-extremity in the absence of chronic skin disease or syndrome: a case report and review of the literature. J Cutan Pathol. 2013 Aug. 40(8):745-52. [Medline].
Pai VV, Shukla P, Bhobe M. Combined planar and eruptive xanthoma in a patient with type lla hyperlipoproteinemia. Indian J Dermatol Venereol Leprol. 2014 Sep-Oct. 80(5):467-70. [Medline].
Aliasgarzadeh A, Ghorbanian M, Naghavi-Behzad M. Familial dysbetalipoproteinaemia presenting with cauliflower xanthoma. Niger Med J. 2013 Jul. 54(4):268-70. [Medline]. [Full Text].
Kalidas K, Behrouz R. Inherited metabolic disorders and cerebral infarction. Expert Rev Neurother. 2008 Nov. 8(11):1731-41. [Medline].
Corradino B, Di Lorenzo S, Triolo A, Moschella F. Laser treatment of giant xanthelasma palpebrarum. Lasers Med Sci. 2014 Sep 25. [Medline].
Moorthy N, Ananthakrishna R, Bhat P, Nanjappa MC. Xanthoma tuberosum in homozygous familial hypercholesterolemia. Ann Pediatr Cardiol. 2014 May. 7(2):118-9. [Medline]. [Full Text].
Fujiwara S, Oka M, Kunisada M, Honjo K, Nishigori C. Severe xanthomatosis with prominent tuberous xanthomas on the cheeks and the nasal dorsum in a patient with type IIa hyperlipoproteinemia. Eur J Dermatol. 2013 Jul-Aug. 23(4):517-8. [Medline].
Agarwal S, Akhtar MN. Great toe gouty tophus-like lesion revealing extensive tendon xanthomatosis in a asymptomatic hyperuricemic patient. J Postgrad Med. 2013 Jul-Sep. 59(3):238-9. [Medline].
Caputo R, Monti M, Berti E, Gasparini G. Normolipemic eruptive cutaneous xanthomatosis. Arch Dermatol. 1986 Nov. 122(11):1294-7. [Medline].
Ansarin H, Berenji Ardestani H, Tabaie SM, Shayanfar N. Xanthoma disseminatum with tumor-like lesion on face. Case Rep Dermatol Med. 2014. 2014:621798. [Medline]. [Full Text].
Hisanaga Y, Akaike Y, Kuroda K. Xanthoma disseminatum with large plaques confined to the back, pulmonary involvement and multiple intestinal xanthomas. Dermatology. 2004. 208(2):164-6. [Medline].
Errichetti E, Piccirillo A, Tataranni M, Ricciuti F, Liao KL, Cheng ZL, et al. A case of diffuse plane normolipemic xanthomatosis presenting with oral lesions. G Ital Dermatol Venereol. 2014 Apr. 149(2):278-80. [Medline].
Mountcastle EA, Lupton GP. Verruciform xanthomas of the digits. J Am Acad Dermatol. 1989 Feb. 20(2 Pt 2):313-7. [Medline].
Kanitakis J, Euvrard S, Butnaru AC, Claudy A. Verruciform xanthoma of the scrotum in a renal transplant patient. Br J Dermatol. 2004 Jan. 150(1):161-3. [Medline].
Reich O, Regauer S. Recurrent verruciform xanthoma of the vulva. Int J Gynecol Pathol. 2004 Jan. 23(1):75-7. [Medline].
Griffel B, Cordoba M. Verruciform xanthoma in the anal region. Am J Proctol Gastroenterol Colon Rectal Surg. 1980 Apr. 31(4):24-5. [Medline].
Becheanu G, Dumbrava M, Arbanas T, Diculescu M, Hoyeau-Idrissi N, Fléjou JF. Esophageal xanthoma–report of two new cases and review of the literature. J Gastrointestin Liver Dis. 2011 Dec. 20(4):431-3. [Medline].
Fernandes EÁ, Santos EH, Tucunduva TC, Ferrari AJ, Fernandes AD. [Achilles tendon xanthoma imaging on ultrasound and magnetic resonance imaging.]. Rev Bras Reumatol. 2014 Nov 1. [Medline].
Griffith JF, Hu M, Yeung DKW, Guo P, Lam SL, Xiao F, et al. Achilles Tendon Xanthomas: Fat-Water Separation at Baseline and after Treatment. Radiology. 2017 Dec. 285 (3):876-884. [Medline].
Jin S, Chae SY, Chang SE, Suh C, Lee SW, Ryu JS. A case of xanthoma disseminatum: evaluation and monitoring by 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Br J Dermatol. 2014 May. 170(5):1177-81. [Medline].
Aldabagh B, Bergfeld W. Eruptive neutrophilic xanthomas. Dermatol Online J. 2010 Apr 15. 16(4):6. [Medline].
Shafer WG. Verruciform xanthoma. Oral Surg Oral Med Oral Pathol. 1971 Jun. 31(6):784-9. [Medline].
Fukuda H, Saito R. Verruciform xanthoma in close association with isolated epidermolytic acanthoma: a case report and review of the Japanese dermatological literature. J Dermatol. 2005 Jun. 32(6):464-8. [Medline].
Inazu A, Koizumi J, Kajinami K, Kiyohar T, Chichibu K, Mabuchi H. Opposite effects on serum cholesteryl ester transfer protein levels between long-term treatments with pravastatin and probucol in patients with primary hypercholesterolemia and xanthoma. Atherosclerosis. 1999 Aug. 145(2):405-13. [Medline].
Fujita M, Shirai K. A comparative study of the therapeutic effect of probucol and pravastatin on xanthelasma. J Dermatol. 1996 Sep. 23(9):598-602. [Medline].
Yamamoto A, Matsuzawa Y, Yokoyama S, Funahashi T, Yamamura T, Kishino B. Effects of probucol on xanthomata regression in familial hypercholesterolemia. Am J Cardiol. 1986 Jun 27. 57(16):29H-35H. [Medline].
Kuo PT, Hayase K, Kostis JB, Moreyra AE. Use of combined diet and colestipol in long-term (7–7 1/2 years) treatment of patients with type II hyperlipoproteinemia. Circulation. 1979 Feb. 59(2):199-211. [Medline].
Bea AM, Perez-Calahorra S, Marco-Benedi V, Lamiquiz-Moneo I, Jarauta E, Mateo-Gallego R, et al. Effect of intensive LDL cholesterol lowering with PCSK9 monoclonal antibodies on tendon xanthoma regression in familial hypercholesterolemia. Atherosclerosis. 2017 Aug. 263:92-96. [Medline].
Szturz P, Adam Z, Rehák Z, Koukalová R. Xanthelasma palpebrarum responding to interleukin-1 blockade. Intern Med J. 2014 Jun. 44(6):617-8. [Medline].
Nakajima K, Ikeda M, Nakajima H, Kodama H. Regression of secondary plane xanthomas using cyclosporine A. Int J Dermatol. 2006 Sep. 45(9):1136-8. [Medline].
Ceska R, Vrablík M, Altschmiedová T, Prusíková M, Urbanová Z, Šobra J. [Familial hypercholesterolemia – past and present. My experiences and findings in our group of patients with familial hypercholesterolemia]. Vnitr Lek. 2014 Nov. 60(11):963-9. [Medline].
Khezri F, Gibson LE, Tefferi A. Xanthoma disseminatum: effective therapy with 2-chlorodeoxyadenosine in a case series. Arch Dermatol. 2011 Apr. 147(4):459-64. [Medline].
Lee EH, Kang TW, Kim SC. Successful treatment of xanthoma disseminatum with simvastatin. J Dermatol. 2011 Oct. 38(10):1015-7. [Medline].
Kim WJ, Ko HC, Kim BS, Kim MB. Successful treatment of xanthoma disseminatum with combined lipid lowering agents. Ann Dermatol. 2012 Aug. 24(3):380-2. [Medline]. [Full Text].
Connolly SB, Lewis EJ, Lindholm JS, Zelickson BD, Zachary CB, Tope WD. Management of cutaneous verruciform xanthoma. J Am Acad Dermatol. 2000 Feb. 42(2 Pt 2):343-7. [Medline].
Miyagawa F, Fukumoto T, Kobayashi N, Asada H. Successful treatment of diffuse normolipemic plane xanthoma with probucol. Case Rep Dermatol. 2013 May. 5(2):148-51. [Medline]. [Full Text].
Haque MU, Ramesh V. Evaluation of three different strengths of trichloroacetic acid in xanthelasma palpebrarum. J Dermatolog Treat. 2006. 17(1):48-50. [Medline].
Haygood LJ, Bennett JD, Brodell RT. Treatment of xanthelasma palpebrarum with bichloracetic acid. Dermatol Surg. 1998 Sep. 24(9):1027-31. [Medline].
Lee HY, Jin US, Minn KW, Park YO. Outcomes of surgical management of xanthelasma palpebrarum. Arch Plast Surg. 2013 Jul. 40(4):380-6. [Medline]. [Full Text].
Yang Y, Sun J, Xiong L, Li Q. Treatment of xanthelasma palpebrarum by upper eyelid skin flap incorporating blepharoplasty. Aesthetic Plast Surg. 2013 Oct. 37(5):882-6. [Medline].
Park EJ, Youn SH, Cho EB, Lee GS, Hann SK, Kim KH, et al. Xanthelasma palpebrarum treatment with a 1,450-nm-diode laser. Dermatol Surg. 2011 Jun. 37(6):791-6. [Medline].
Raulin C, Schoenermark MP, Werner S, Greve B. Xanthelasma palpebrarum: treatment with the ultrapulsed CO2 laser. Lasers Surg Med. 1999. 24(2):122-7. [Medline].
Basar E, Oguz H, Ozdemir H, Ozkan S, Uslu H. Treatment of xanthelasma palpebrarum with argon laser photocoagulation. Argon laser and xanthelasma palpebrarum. Int Ophthalmol. 2004 Jan. 25(1):9-11. [Medline].
Zhao Y, Wen CM, Zhou NN, Feng Q, Tu P. 1064-nm Q-switched Nd:YAG laser is an effective and safe approach to treat xanthelasma palpebrarum in Asian population. J Eur Acad Dermatol Venereol. 2014 Jun 9. [Medline].
Sonthalia S, Arora R, Sarkar R. Successful cosmetic ablation of xanthelasma palpebrarum with low-voltage radiofrequency: back to the basics!. Dermatol Surg. 2014 Dec. 40(12):1443-4. [Medline].
Esmat SM, Elramly AZ, Abdel Halim DM, Gawdat HI, Taha HI. Fractional CO2 laser is an effective therapeutic modality for xanthelasma palpebrarum: a randomized clinical trial. Dermatol Surg. 2014 Dec. 40(12):1349-55. [Medline].
Heng JK, Chua SH, Goh CL, Cheng S, Tan V, Tan WP. Treatment of xanthelasma palpebrarum with a 1064-nm, Q-switched Nd:YAG laser. J Am Acad Dermatol. 2017 Oct. 77 (4):728-734. [Medline].
Nguyen AH, Vaudreuil AM, Huerter CJ. Systematic review of laser therapy in xanthelasma palpebrarum. Int J Dermatol. 2017 Mar. 56 (3):e47-e55. [Medline].
Mendelson BC, Masson JK. Xanthelasma: follow-up on results after surgical excision. Plast Reconstr Surg. 1976 Nov. 58(5):535-8. [Medline].
Borelli C, Kaudewitz P. Xanthelasma palpebrarum: treatment with the erbium:YAG laser. Lasers Surg Med. 2001. 29(3):260-4. [Medline].
Hsu MC, Lee CH, Chen GS, Wu CY. Nonablative 1,450-nm diode laser treatment for xanthoma disseminatum. Dermatol Surg. 2014 Dec. 40(12):1423-5. [Medline].
Kara Melissa T Torres, MD, DPDS Visiting Research Fellow, Ackerman Academy of Dermatopathology
Kara Melissa T Torres, MD, DPDS is a member of the following medical societies: Philippine Dermatological Society
Disclosure: Nothing to disclose.
Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.
Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology
Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association
Disclosure: Nothing to disclose.
Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine
Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology
Disclosure: Nothing to disclose.
Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.
Ponciano D Cruz, Jr, MD Professor and Vice-Chair, Paul R Bergstresser Chair, Department of Dermatology, University of Texas Southwestern Medical Center
Ponciano D Cruz, Jr, MD is a member of the following medical societies: Texas Medical Association
Disclosure: Received consulting fee from RCTS for independent contractor; Received honoraria from Mary Kay Cosmetics for consulting; Received grant/research funds from Galderma for principal investigator.
Kevaghn P Fair, DO Consultant Pathologist and Founder, Dominion Pathology Laboratories
Kevaghn P Fair, DO is a member of the following medical societies: American Society for Clinical Pathology, American Society of Dermatopathology, and College of American Pathologists
Disclosure: Nothing to disclose.
Xanthomas
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