what is Xanthelasma?

Xanthelasma palpebrarum is the most common form of xanthoma,its is a skin lesion due to deposition of cholesterol. The lesions appear as yellowish, flat, and soft and are located mostly at the medial angle of the eyelid . This frequently occurs around the eyelids and indicates can sometimes significant hypercholesterolemia, however can also be hereditary in the setting of normal cholesterol levels. When a xanthelasma grows large or is located around tendons, it is sometimes referred to as a xanthoma.

 

Although xanthelasma is a benign condition and almost never limits functioning, its appearance is often seen as cosmetically disturbing. Surgical excision has been the treatment of choice for decades. Alteration in apolipoprotein levels (A1 and B) in XP patients may predispose to cutaneous and systemic deposition of lipids, including atherosclerosis. Therefore, XP patients irrespective of their lesion size or serum lipid levels should be screened using CIMT for detection of subclinical atherosclerosis. However, this normally effective measure bears a considerable risk of side effects, especially an ectropion, which could lead to additional procedures, e.g., full thickness skin graft . Recently, several case reports have described the successful treatment of xanthelasma with the carbon dioxide laser, mostly in the continuous mode . The uncontrollable penetration depth of the laser beam in the continuous mode explains the high risk of scarring and posttherapeutic pigmentary changes. This has lead to the development of superpulsed and ultrapulsed CO2 lasers, which deliver the energy in a defined laser flash.