Xanthelasma Palpebrarum (XP) is the most common form of xanthoma, presenting as soft, yellowish patches around the eyelids, usually near the inner corners. While it is a harmless condition, many seek treatment due to cosmetic concerns. Interestingly, XP is more than just a skin change — it can reflect underlying metabolic health.
Pathophysiology: The condition develops when lipid-loaded foam cells accumulate in the dermis of the eyelids, leading to the characteristic yellow plaques. About half of XP cases are associated with dyslipidemia, especially elevated LDL cholesterol or triglycerides, though it may also occur in individuals with normal lipid levels. Conditions such as diabetes, hypothyroidism, and liver disease have also been linked to XP, making it an important clinical marker.
Epidemiology: Recent trends highlight XP as a cutaneous indicator of cardiovascular risk, particularly in younger individuals, where it may hint at premature atherosclerosis. This makes lipid profile testing and cardiovascular evaluation essential whenever XP is diagnosed.
Management: Management includes controlling lipid abnormalities through diet, lifestyle modifications, and medications like statins. For cosmetic reasons, removal can be attempted with surgical excision, laser therapy, cryotherapy, or chemical cautery. However, recurrence is common.
During my internship in various hospitals, I’ve myself came across with these cases a lot. And to my surprise all of them had similar findings-elevated triglyceride levels or dyslipidemia.
With pedigree analysis we came to an interesting pattern of their passing onto generations and how patients having these were mostly having underlying CVD. Not just dyslipidemia was transferred, it’s presentation was also transferred.
MBH/PS