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Image Number 644 (Xanthelasma)

 
Morphology:
Papules,yellow

Diagnosis: Xanthelasma

Site: Eyelids

Sex: F

Age: 49

Type: Clinical

Description: Soft yellowish orange color tumor near the inner canthi of upper palpebra.

Submitted by: Mehravaran Mehrdad

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Differential Diagnosis

History: A 49 year-old female with positive history of rheumatoid arthritis, and under therapy of methylprednisolone (Medrol®),and  methotrexate. In addition to xanthelasma there are telangiectasias on the nose and cheeks duo to long-term use of corticosteroids. Xanthelasma Palpebrarum (Xanthelasma) is the most common type on xanthoma. It occurs on the eyelids, being characterized by soft, chamois-colored or yellowish orange oblong plaques, usually near the inner canthi. They vary from 20-30 mm in length. Frequent symmetry, with a tendency to be permanent, progressive, multiple, and coalescent, is also characteristic. The disorder is encountered chiefly during middle age. It is common among women who have hepatic or biliary disorders. Xanthelasma however, may be seen in the various familial hyperlipoproteinemias, especially in familial hypercholesterolemia; half or more of the patients are nomolipemic. It is a common finding in generalized xanthoma planum, in obstructive liver disease, myxedema, and diabetes.

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