Cutaneous xanthomas; a reappraisal of their significance.

Abstract

Xanthomas have been known to man for centuries and their clinical description was recorded by Thomas Addison in 1848, 1 long before modern medical diagnostic techniques were evolved. Accordingly, our understanding of xanthomas resulted chiefly through observation of minute morphological differences in lesions, the recording of various distributional patterns, and the occasional detection of some associated state such as jaundice, diabetes, or a familial tendency. A relatively complex terminology resulted, i. e. xanthoma disseminatum, xanthoma diabeticorum, biliary xanthomatosis, etc. This nomenclature frequently did not reflect distinguishing morphological characteristics among various xanthomatous lesions but merely reflected differences of associated conditions in individual patients and histories. The growth of physiological chemistry and the development of modern serum analytic techniques has largely replaced the need for such a complex morphological approach and has rendered much of this traditional terminology obsolescent. Morphology Xanthomas are circumscribed dermal infiltrations of cholesterol