Xanthelasma Research Articles

Clinical association between serum cholesterol level and the size of xanthelasma palpebrarum.

BackgroundXanthelasma palpebrarum (XP) is a benign periorbital lesion. The relationship between xanthelasma lesion size and serum cholesterol levels has been poorly studied. In this study, we investigated this relationship in the context of the clinical etiology of XP. MethodsWe retrospectively reviewed medical records and pathology reports of all patients treated for XP at our hospital between June 2014 and June 2021; the data were used to analyze lesion size, underlying disease, serum cholesterol, and disease recurrence.ResultsThe mean values for patient age, serum cholesterol, and lesion size were 53.0 years, 235.0 mg/dL, and 69.2 mm2, respectively. XP mainly occurred in women (64.7%); furthermore, the incidence of XP and lesion size was greatest among patients in their 5th decade of life (41.2%). There was no statistically significant relationship between xanthelasma lesion size and serum cholesterol level.ConclusionThis study compared lesion size with various clinical features in XP patients. In patients who underwent surgery for XP, serum cholesterol levels tended to be higher than those in the general population. However, the trend between the size of XP and serum cholesterol level was unclear. Therefore, if a patient with XP visits the hospital for surgery, it is recommended to check the lipid profile to confirm underlying dyslipidemia regardless of the size.

The relation between coronary angiographic findings and lipoprotein (a) in patients with chronic stable angina with and without xanthelasma

IntroductionAtherosclerosis develops in many patients in the absence of classical risk factors. The serum level of lipoprotein [Lp (a)] is of utmost importance in such cases. Many patients with elevated serum level of Lp (a) have xanthelasma with elevated total cholesterol and low-density Lp cholesterol levels.AimTo find the relation between the level of Lp (a) and the severity of coronary artery disease (CAD) in patients with chronic stable angina with and without xanthelasma.Patients and methodsThe study was carried out on 86 patients in the National Heart Institute. The patients were divided into two groups: group A (43 patients), with xanthelasma, and group B (43 patients), without xanthelasma. The patients were subjected to full clinical examination, echocardiographic examination and laboratory investigations, including the level of Lp (a) and coronary angiography.ResultsThe age in patients with xanthelasma was significantly more than in those without xanthelasma but sex difference was not significant. Hypertension, diabetes mellitus, and dyslipidemia were significantly more common in patients with xanthelasma. Creatinine level, total cholesterol level, and low-density lipoprotein level were significantly higher in patients with xanthelasma. Lp (a) level is also significantly increased in patients with xanthelasma. The severity of CAD was significantly increased in patients with xanthelasma, and the level of Lp (a) was an independent predictor for left main disease.ConclusionThere is a significant relation between xanthelasma palpebrarum (as a cutaneous marker of atherosclerosis) and Lp (a), and both of them are independent and causal risk factors for atherosclerotic CAD.

Quantitative assessment of xanthelasma palpebrarum treated by argon laser photocoagulation using ImageJ software

Purpose The aim of this study was to evaluate the effect of argon laser photocoagulation on xanthelasma using ImageJ software. Patients and methods The study included 41 eyes of 23 patients (49 individual xanthelasmic lesions). All lesions were treated by a single session of argon laser photocoagulation. The lesions were assessed prelaser and postlaser using ImageJ software. Results All xanthelasmic lesions improved in height and color. The pretreatment mean height in ImageJ was 168.93±11.64 pixels, while the mean posttreatment height was 131±8.39 pixels (P<0.001). The color moderately improved in 24.4% of the cases and markedly improved in 68.3% of the cases. Conclusion Argon laser treatment of xanthelasma is a safe and effective treatment modality. This finding was documented using ImageJ software.

Relationship between plasma atherogenic index and xanthelasma palpebrarum

Introduction: Xanthelasma is a common form of skin xanthoma. It is due to abnormal lipid deposition in the eyelid skin. Xanthelasma is thought to be a sign of dyslipidemia, one of the important risk factors in atherosclerosis. The risk of atherosclerotic disease can be determined using the atherogenic index of plasma (AIP) parameters. AIP is a mathematical relationship between TG and HDL in logs (TG/HDL). Thus, this study aimed to determine the relationship between the atherogenic index of plasma and xanthelasma palpebrarum at the Polyclinic of the Department of Dermatology and Venereology, Universitas Sumatera Utara Hospital.Methods: This study was an observational analytic study with a cross-sectional approach involving 50 patients with xanthelasma palpebral and 50 controls based on inclusion and exclusion criteria. Gender, age, lipid profile values (cholesterol, HDL, LDL, and triglycerides), and Atherogenic Index of Plasma (AIP) values were recorded. Laboratory tests measured assessment atherogenic index of plasma to determine triglyceride (TG) and high-density lipid (HDL) levels using the Cobas 6000 C501 device. An independent t-test was conducted to assess the relationship between research variables, and it was declared significant with p &lt; 0.001.Results: The majority of xanthelasma palpebrarum occurred in women (94%), and the mean value of the subjects of this disease was higher in the 50-59 year age group (42%). The mean value of lipid profile (total cholesterol, LDL, HDL, and triglycerides) in xanthelasma palpebrarum subjects tends to increase compared to subjects without xanthelasma palpebrarum. The results obtained using the logistic regression test showed that there was a significant relationship between plasma atherogenic index (AIP) values and xanthelasma palpebrarum (p &lt; 0.001). In the group with xanthelasma palpebrarum, the highest proportion were subjects with an IAP value &gt; 0.21 (high risk), and the risk of experiencing xanthelasma palpebrarum was 7.714 times greater than subjects with an AIP &lt; 0.11 (low risk).Conclusion: There is a relationship between plasma atherogenic index and xanthelasma palpebrarum.

Animal experimental research of intralesional bleomycin and pingyangmycin in the treatment of xanthoma.

Xanthelasma palpebrarum is a type of human xanthoma that occurs on the skin of human eyelids and is a benign skin lesion. Pingyangmycin (also known as bleomycin A5) is one of the 13 components of bleomycin. The aim of this study was to explore the efficacy of intralesional bleomycin and pingyangmycin in the treatment of xanthoma based on histopathological observations in animal experimental research. An animal model of xanthoma was established by feeding rabbits with a high-cholesterol diet. Pingyangmycin and bleomycin interfered with the skin xanthoma of the animal model. Skin tissue specimens were stained with hematoxylin-eosin and oil red O to evaluate the effect of the intervention. A xanthoma animal model was established. Pingyangmycin and bleomycin could reduce the abnormal lipid deposition in the lesion area of the skin xanthoma of the animal, via a local injection. In addition, pingyangmycin was more effective than bleomycin in eliminating lipid deposition in rabbit skin xanthoma.

Pleomorphic Xanthomas

Xanthomas are the subcutaneous lipid deposits which can be seen in normolipedemic or hyperlipidemic conditions. Xanathomas are usually of single type and presence of polymorphic xanthomas arise suspicion of dyslipidemia. We report a case of young girl presenting with pleomorphic xanthomas (Xanthelasma palpebrarum, intertriginous Xanthomas, tendon Xanthomas, and eruptive xanthomas), hypothyroidism and multiple cardiac valvular involvements with very high serum total cholesterol and low-density lipoprotein along with deranged lipid profile in both parents. Pleomorphic xanthoma arouses a suspicion and helped in making a diagnosis of rare homozygous familial hypercholesterolemia.

Risk of Non-Alcoholic Fatty Liver Disease in Xanthelasma Palpebrarum.

BackgroundXanthelasma palpebrarum (XP) is a sign of hyperlipidemia and is closely linked to atherosclerosis. Since fatty liver shares similar risk factors with atherosclerosis, we hypothesized that patients with XP are also at risk of non-alcoholic fatty liver disease (NAFLD).MethodsIn this retrospective cohort study, 37 patients with XP were compared with sex- and age-matched controls undergoing general health examination. Moreover, demographic information and lipid profiles were compared. The risk of NAFLD was evaluated using the hepatic steatosis and ZJU indices. In addition, we analyzed publicly available RNA sequencing data from the GSE48452 and GSE61260 datasets in the Gene Expression Omnibus database.FindingsPatients with XP had higher scores of hepatic steatosis index (37 ± 1.13 vs 32 ± 0.82, p=0.0006) and ZJU index (38.77 ± 1.0 vs 33.88 ± 0.74, p=0.0002). In addition, they had higher levels of lipid parameters, including total cholesterol, low-density lipoprotein (LDL), and fasting glucose. Among patients with fatty liver, individuals presenting with XP showed higher serum levels of total cholesterol (216 ± 10.4 vs 188.9 ± 7.6, p=0.04), fasting glucose (117.1 ± 6.4 vs 98.3 ± 2.4, p=0.002), and low-density lipoprotein (145.1 ± 8.7 vs 115.6 ± 6.4, p=0.009) than those without XP. In gene expression analysis, individuals presenting with non-alcoholic steatohepatitis showed higher Z scores of xanthelasma than those without non-alcoholic steatohepatitis.ConclusionOur results suggest that individuals with XP have a higher risk of progression to NAFLD and develop a more severe dyslipidemia.

Xanthelasma palpebrarum removed with Atmospheric Plasma technique: 11-year follow up.

Xanthelasma palpebrarum is a subcutaneous lesion of the lid and cause a cosmetical issue. The aim of the present study was to evaluate the atmospheric plasma treatment for the treatment of xanthelasma with an 11-year follow up. Seventy-two patients with bilateral xanthelasma and 26 patients with unilateral xanthelasma by atmospheric plasma technique known also as voltaic arc dermabrasion (VAD, Europe Medical s.r.l. Montesilvano (PE), Italy). Photographs were obtained at the baseline and after the procedure and analyzed by an independent observer. The evaluation of the results was made 2 months after this single treatment with 11 years of follow up. The subjects average age was 48.5 years (range 41-63 years). All subjects were elected for a single session for the lesion removal. The erosion is epithelialized from the lesion margins and the dermal basal cells. After 2 months from the treatment, the result was scored as 4 (clearing of lesions > 75%, complete resolution) in 66 patients for a total of 104 lesions treated; scored as 3 in 24 patients for a total of 48 lesions, and as 2 in nine patients for a total of 18 lesions. No subjects scored 0 or 1. A total of 8 lesions showed mild erythema in the treated areas for 1 month. Numerous approaches were proposed for xanthelasma exeresis such as a surgical treatment especially in case of excessively large lesions or lesions involving the medial canthus that could produce a more limited skin laxity rapidly induces a risk of ectropion. In conclusion, the effectiveness of the present investigation suggest that the atmospheric plasma is a useful therapeutic option for the treatment of xanthelasma palpebrarum.

A Comparison of Efficacy and Safety of Fractional Carbon Dioxide Laser and Fractional Er:YAG Laser for the Treatment of Xanthelasma Palpebrarum: A Two-Center Randomized Split-Face Controlled Trial

Background: Xanthelasma palpebrarum (XP) is a form of cutaneous xanthoma that presents as collections of yellowish papules or plaques around the eyelids or canthus, affecting patients cosmetically. Objective: This study aimed to compare the efficacy and safety of fractional carbon dioxide (CO2) laser to that of fractional Er:YAG laser for the treatment of XP. Methods: Two centers recruited patients diagnosed with XP of bilaterally symmetrical lesions. The lesion on one side was randomly assigned to be treated with fractional CO2 laser while the lesion on the other side was treated with fractional Er:YAG laser. All subjects received up to five treatments, with a 4-week interval between each treatment. Results: Thirty-nine patients completed the study and a total of 82 lesions were available for final assessment. The percentage of "Excellent Improvement" on third and fourth visit was 60.98% versus 39.02% and 90.24% versus 63.41%, respectively, p < 0.05. In a follow-up for 12 to 25 months, the number of lesions recurred on the side treated with fractional CO2 laser and fractional Er:YAG laser are 9 (22%) and 10 (24%), respectively. Conclusions: In this study, fractional CO2 laser therapy appears superior since a fewer treatments are required for patients to show significant clinical improvement.

Efficacy of ultrapulse carbon dioxide laser ablation versus 30% trichloroacetic acid in xanthelasma palpebrarum - A randomised controlled trial

Context: Xanthelasma palpebrarum (XP) is the most common cutaneous xanthoma that develops around the eyes. A number of treatment modalities have been tried for its removal, but none are truly satisfactory. Trichloroacetic acid (TCA) is commonly used in Indian setting as it is easily available and cost-effective whereas carbon dioxide (CO2) laser has been tried increasingly due to its favorable cosmetic outcome. Aims: This study aims to compare the efficacy of ultrapulse CO2 laser ablation with 30% TCA in the treatment of XP. Setting and Design: Prospective, interventional, randomized study at a Dermatology Centre of a Tertiary Level Hospital from January 2017 to June 2018. Methods: Seventy-four patients with 100 lesions of XP were divided into two groups of flat and elevated lesions. Each group was further randomly divided into two subgroups and administered CO2 laser once a month and 30% TCA once in 2 weeks respectively for 3 months. Patients were clinically assessed at baseline and then at monthly intervals using visual analog scale (VAS), patient satisfaction score (PSS), and standardized photographs. The follow-up was done at the end of 3 and 6 months. Statistical Analysis and Results: Mean PSS and VAS score of TCA and laser in flat and elevated lesions were compared using independent group Student's t-test. Response to laser in elevated lesions was found to be statistically better whereas in flat lesions the response to TCA and laser were similar. Recurrence was 17% and 6% at 3 months' follow-up and 24% and 11% at 6 months' follow-up in TCA and laser groups, respectively. Conclusions: The end results of ultrapulse CO2 laser and 30% TCA are comparable in flat lesions of XP. In elevated lesions, laser has better efficacy, requires fewer sittings with lesser chance of recurrence.

A Prospective Interventional Study of Xanthelasma Palpebrarum Treated with Ultrapulse Carbon Dioxide Laser

Introduction: Xanthelasma palpebrarum (XP) is the most common of all the xanthomas which presents as asymptomatic, often bilateral, soft, yellow, papules and plaques around the eyelids. Although, the lesions are benign, it is aesthetically upsetting. The surgical laser is the most effective treatment modality to this problem. Aim: To evaluate the efficacy and safety of ultrapulse Carbon dioxide (CO2) laser in XP in Indian patients. Materials and Methods: It is a prospective, interventional study carried out for two years in which 29 patients with 61 XP lesions were part of the study. Ultrapulse CO2 (Fraxis Duo laser; 10,600 nm) laser treatment was done in every patient for a single sitting. Statistical significance was calculated using Chi-square test using Statistical Packages for Social Sciences (SPSS) version 19.0. The p-value of 0.001 was considered statistically significant. Results: A total number of 29 patients with 61 xanthelasma lesions were included in the study, of which 11 were males and 18 were females with an age range of 27-54 years. In the present study XP lesions were completely resolved in majority (54 lesions in 25 patients) of treated patients. No intraoperative complications were observed. Two patients showed hypopigmentation. There was neither scarring nor recurrence seen after six months follow-up. Conclusion: Ultrapulse CO2 laser is a safe and effective option of treatment for xanthelasma. It is considered as less painful procedure with fewer side effects and recurrences in the present study.

A Modified Surgical Method Combined with Blepharoplasty Design for Treatment of Xanthelasma Palpebrarum.

Purpose Xanthelasma palpebrarum manifests as a yellowish placoid on the medial aspect of the upper eyelids, often in middle and old age. Aggravated lateral hooding of the eyelid might cause a deformity with conventional surgery, which appears to be more deficient on the medial side with excess hooding of the lateral skin. The authors suggest a novel surgical technique to solve this problem and reconstruct the defect appropriately. Methods From July 2017 to December 2018, our method of combining excision with blepharoplasty was performed on 8 patients, consisting of 15 lesions on the upper eyelid and 6 lesions on the lower lid. Lesion removal incorporating blepharoplasty incision was done. After resection, the orbicularis oculi musculocutaneous flap was widely elevated extending through the whole upper eyelid with the lateral flap first along with fat maneuver. The flap was advanced into the defect, with even distribution of tension, after lower flap fixation to the required height of the eyelid fold. Taping was done with a hydrocolloid bandage and kept for 2 weeks. Results The wounds were healed primarily, and no cases of recurrence, lagophthalmos, hypertrophic scar, pigmentation, or remarkable deformity were noted. All patients were satisfied, and the functional outcomes were excellent. Two patients had trivial complications specific to our method, that of triple fold and neo-Mongolian fold, which were simply revised later. Conclusions This modality overcame the drawbacks of eyelid deformity observed in previous surgical methods, giving excellent results without any critical complications.

Successful treatment of xanthelasma palpebrarum with a combination of radiofrequency ablation and wound suturing.

Xanthelasma palpebrarum is a common disfiguring condition of eyelids often causing cosmetic concern and psychological distress. Various treatment modalities have been used to clear the lesions but none have been found to be fully satisfactory. To evaluate a novel combination of radiofrequency (RF) ablation and primary wound closure for treatment of xanthelasma palpebrarum (XP). Forty-five patients were selected after clinical examination and grading of lesions. Radiofrequency ablation was used to remove the lesion followed by suturing of the wound. Efficacy of treatment was evaluated on the basis of clinical examination and photographic images. Excellent response was seen in all patients. Of these, in 43 patients complete clearance could be achieved in a single sitting. In the other 2, an additional sitting of RF was done because of the presence of either multiple lesions or significant projection from the main lesion. Recurrence was seen in only two patients at the end of one year. Radiofrequency removal combined with wound closure showed excellent response with good cosmetic result, no scarring, and rare relapse at end of 1year. This was achieved in 43(96%) of the total 45 patients in a single sitting.

Fractional CO2 laser versus trichloroacetic acid 50% for xanthelasma palpebrarum therapy.

Although being a benign lesion, xanthelasma palpebrarum (XP) causes cosmetic concerns. There are numerous therapeutic methods for XP with adverse events for each method. Evaluate the safety, efficacy, and downtime of fractional CO2 laser (10600nm) versus 50% trichloroacetic acid (TCA) in XP therapy. Comparative interventional prospective study involved 20 adult patients with XP. Each patient received a split-face therapy where xanthelasma lesions treated with fractional CO2 laser on the one side and TCA 50% on the other side for maximum 5 sessions with 2-week intervals in between. Statistically significant improvement in lesion color, thickness, and size by both fractional CO2 and TCA 50%, with nonstatistically significant difference between both therapeutic modalities after treatment, although downtime, number of sessions, and patient's satisfaction were significantly better for fractional CO2 laser. Fractional CO2 laser (10600nm) is ideal for treatment of xanthelasma because it is safe and effective with short downtime, more patient satisfaction, less sessions, and less complications compared with chemical peeling using TCA (50%).

Evaluation of The Efficacy of Argon Laser in Treatment of Xanthelasma Palpebrarum using Ultrasound Biomicroscopy

Background: Xanthelasma palpebrarum [XP] is the most common of the xanthomas with asymptomatic, symmetrical, bilateral, soft, yellow, polygonal papules around the eyelids. The surgical laser offers an extremely elegant and powerful solution to this problem. Aim of the work:To evaluate the efficacy of Argon Laser in treatment of xanthelasma palpebrarum, based on ultrasound biomicroscopy [UBM]. Preoperatively, full history and clinical examination had been carried out. Patients and Methods: The study included 45 eyelids of 27 patients [13 males and 14 females] presenting with xanthelasma lesion. They underwent single session treatment of XP by Argon Laser, which had been performed on an outpatient basis. Postoperative UBM had been used to ensure eradication of the lesion. Follow up of the patient every 2 weeks in the first month then after 6 months]. Results: The UBM was successfully used preoperatively to determine the maximal lesion thickness that can be effectively safely eradicated in only single session. The therapy was well tolerated, and all lesions responded to the therapy in only single session. There were no functional or relevant aesthetic complications. The cosmetic outcome was considered to be excellent in 80% and good in 6.7%of the cases. The study included 45 eyelids, 36 [80.0%] of them had excellent, 3 [6.7%] had good, 2 [4.4%] had satisfactory and only 4[8.9%] patients had poor cosmetic outcome. There were no recorded recurrent cases [0.0%] in the present study. Conclusion: Argon laser photocoagulation [single session] represents an alternative treatment in selected cases. It is easy to be performed well tolerated by the patients. In addition, UBM was important to determine the maximal lesion thickness that can be eradicated safely in only one session.

An Algorithmic Approach for Lipid Metabolism and Management of Patients with Xanthelasma Palpebrarum (XP)

Abstract Objectives XP (flat, yellowish plaques around the eyes) is difficult to treat and often recurs. We describe an algorithmic approach to explore the lipid metabolism and management of XP. Methods A 64 yo female with hypothyroidism, obesity, and metabolic syndrome was successful with weight loss and glycemia but noted recurrence of XP after a surgical excision. Her lipid profile (on rosuvastatin) revealed: total cholesterol 150 mg/dL, LDL 54 mg/dL, triglycerides 74 mg/dL, HDL 81 mg/dL. Apolipoprotein (Apo) A1 was 213 mg/dL (nl female &amp;gt; 140). Apo B100 was 63 mg/dL (nl &amp;lt; 130). Lp(a) was 29 mg/dL (nl &amp;lt; 30). LDL particles were 958 nmol/L (nl &amp;lt; 1000). LDL particle size was 20.9 nm (nl &amp;gt; 20.5). Small dense LDL particles were 598 nmol/L (nl &amp;lt; 528). There was presence of serum campesterol (3.7 mg/L; nl 0–7.0) and sitosterol (2.1 mg/L; nl 0–5.0), but not desmosterol or lathosterol. Oral ezetimibe (EZ), 10 mg/day was administered. After 8 months of therapy, campesterol and sitosterol dropped significantly (campesterol: 2.1, - 44%; sitosterol: 1.3, - 39%). XP lesions resolved completely. Results We developed an algorithmic approach to XP management. The sequence is as follows: 1) examine standard lipid levels, 2) examine levels of pro-atherogenic particles, 3) explore net cholesterol tissue transport, 4) confirm hepatic cholesterol synthesis suppression, 5) examine plant sterols, 6) treat the abnormalities detected. In this example case phytosterols were responsible for XP recurrence. Sitosterol and campesterol should be minimally absorbed by the gut through the Nieman Pick C1 Like 1 (NPC1L1) sterol influx transporter and eliminated by the sterol efflux transporters, adenosine triphosphate-binding cassette (ABC) ABCG5/ABCG8. If phytosterols are retained in the body, they may predispose to resistant XP. An algorithmic approach to XP suggested that hyper-absorption of plant sterols by the NPC1L1 transporter was present. This was clinically confirmed because inhibition of NPC1L1 transport (by EZ) significantly reduced plant sterol levels. Plant sterols were also clinically confirmed as the cause of her XP, since their reduction and led to XP resolution. Conclusions We present an algorithmic approach to help detail the metabolic etiology of XP and direct its management. The example case demonstrates its value to reduce XP recurrence and resolve XP in selected cases. Funding Sources None.

Clinical and serum lipid profiles and LDLR genetic analysis of xanthelasma palpebrarum with nonfamilial hypercholesterolemia.

XP is a flat xanthoma that usually presents as bilateral, symmetrical, soft, yellowish papules over the eyelids. The etiology of XP is unknown, but it may be related to complex heterozygous mutations. To investigate the lipid profiles, important clinical characteristics, and low-density lipoprotein receptor (LDLR) gene mutation in the patients suffering from xanthelasma palpebrarum (XP) with nonfamilial hypercholesterolemia. The prospective study included 25 individuals of XP with nonfamilial hypercholesterolemia, and 30 controls neither with XP nor familial hypercholesterolemia (FH). Each one underwent detailed clinical examination, serum lipid profile, and LDLR gene detection at the 400th exon and the 1246th exon. In our study, patients with XP were often not present with FH and family history. The mean serum cholesterol (CHOL) (5.20±1.82) and the prevalence of carotid atherosclerosis (4.34±0.78) were significantly higher in study group, while there was no statistically significant difference between two groups in terms of triglyceride (TG) (P=.38) and low-density lipoprotein (LDL) (P=.23). Unusually, the mean levels of high-density lipoprotein (HDL) (1.59±0.31) in the study group were much higher than the controls (1.31±0.30), and the LDLR gene mutation was not found. Clinical and serum lipid profiles indicated that XP was sporadic and underlying lipid abnormalities especially higher HDL. XP did not occur with mutations in the LDLR gene at the two exons. We suggested too high HDL level may be contributed to pathogenesis of XP and XP is often not associated with FH.

Association of Xanthelasma palpebrarum (XP) with cardiovascular disease (CVD) risk factors

Xanthelasma palpebrarum (XP) is the most common cutaneous xanthoma occurs over or surrounding the eyelids in yellowish color and various shapes. The objective of this study was to describe the status of cardiovascular disease risk factors in XP patients and determine their association with XP. A case-control study was conducted among 81 cases (have XP) and 81 controls (no XP) among patients attended for cardiac check-up between January 2019 to July 2019 at Ad-Din Women's Medical College Hospital, Dhaka, Bangladesh. Among 162 subjects were interviewed in our study, majority were female (62.3%). XP were found more prevalent among female and several cardiac risk factors were significantly associated with XP. The chi-square analysis indicates gender (p=0.035), BMI (p=0.01), Angina history (p=0.008), and serum LDL (p=0.024) were significantly associated with presence of XP. A higher percentage of patients with high total serum cholesterol, TG levels, and LDL was observed in patients with XP in compared to control group. Our study reveals an increased presence of cardiovascular disease risk factors among patients with xanthelasma. Moreover, a statistically significant association of gender, BMI, angina history, and serum LDL with XP were observed.&#x0D; Asian J. Med. Biol. Res. June 2019, 5(4): 324-329

Intralesional injection of bleomycin in the treatment of xanthelasma palpebrarum: A clinical study.

Xanthelasma palpebrarum (XP) is the most common type of cutaneous xanthoma and has been treated with intralesional injection of pingyangmycin effectively. However, bleomycin, which has the same effect in antitumor activity as pingyangmycin, has not been applied in the treatment of XP. To explore and assess the treatment of xanthelasma by intralesional injection of bleomycin, which has been widely used as an antitumor antibiotic, for the replacement of pingyangmycin. Intralesional injection of different concentrations of bleomycin was administered to 44 xanthelasma lesions of 24 patients who have never been treated before, divided into two groups according to age. Photographs were taken and analyzed to assess the therapeutic efficiency. Patients were then followed up for 6-24months. All the lesions resolved after 1month of treatment with the intralesional injection of different concentrations of bleomycin. There was no significant difference observed between the two groups. No severe complications had occurred. The treatment of XP with intralesional injection of bleomycin is minimally invasive, safe, and effective. Consequently, it also has good cosmetic outcome with no adverse effects.

Plasma sublimation for the treatment of xanthelasma palpebrarum

Xanthelasma palpebrarum (XP) is a common xanthomatous lesion of the eyelid and periorbital skin. Several methods of treatment have been reported in the literature, each having its own indications and risks. We present a new treatment method for removing XP using a plasma exeresis device (Plexr®, GMV, Italy). Fifteen patients with a total of 27 treated XPs were assessed and clinically identified by the treating dermatologist. Patients were photographed and assessed by a dermatologist prior to and immediately after treatment. A patient survey was conducted 12 months after the procedure, which assessed the outcome of the procedure (redness, pigmentation disorders, and scars). After just a single treatment session using a plasma sublimation, all 27 XPs showed complete clearance. There were no reports of scars, pigmentary alteration, or recurrence of lesions up to 12 months. We present plasma sublimation as a new method for the treatment of XP. During the procedure, the method allows to control the depth of tissue destruction and the presence of xanthoma tissue, and to minimize pain and trauma, making it particularly ideal for treating areas around the eye.