What is Xanthelasma? Xanthelasmas And Xanthomas

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What is Xanthelasma?

Xanthelasmas are a particular type of Xanthoma. Xanthomas can appear on any part of the human body and are addressed as Xanthelasmas whenever they appear on the eyelids or around the eyelids.

Xanthomas and Xanthelasmas

Xanthomas on the top two pictures and Xanthomas on the eyelids (referred to as Xanthelasmas) at the bottom.

Xanthomas can appear on any part of the body they are very common on to be growing on the Achilles heels. When they are found on the Achilles heels are found pressing on the tendons underneath the skin. The main peculiarity of this type of Xanthoma is that it grows underneth the dermis, whereas most other types of Xanthomas are found between the dermis and epidermis.

Xanthomas on Achilles heels

Xanthomas on Achilles Heels

When found on the Achilles heels the Xanthomas can cause particular discomfort to the client and the client may request to have them removed because they represent an impediment comfort while walking and running. However no Xanthoma is a malignant growth and therefore is can be left untreated without compromising the longevity of the client.

Xanthomas on Achilles Heels

Xanthomas compromising walking and wearing standard footwear.

 Xanthomas on the Achilles Heels can keep growing if left untreated. The only treatment known to date (apart of dietary and lifestyle chages) is surgery. Surgery, for this type of condition, is only advisable once the condition becomes too discomforting to the client. This is because, despite the simple procedure required for this type of Xanthoma removal, any surgery presents risks.  Achilles heels Xanthoma surgery is particularly safe to perform because:

  • No general anaesthetic is required unless the Xanthoma is particularly large.
  • The area affected by the Xanthomas is not close to any important artery.

 

Xanthomas on Achilles Heels

Xanthomas on Achilles Heels

As we can see from the above picture the footwear worn by the client over time can affect the way the Xanthomas develops. Surgery for removal of this type of Xanthoma will lead to scarring. This is because of where the Xanthomas grows on the Achilles Heels inside the skin beneath the dermis itself and therefore the scar left will be due to the deep incision required forthis Xanthoma removal.

Xanthoma MRI

Xanthoma MRI

This Xanthoma MRI Shows clearly how this type of Xanthoma develops inside the skin and presses on the tendons (figure A and B). Figure C at the bottoms shows how this type of xanthoma looks under the microscope. Quite similar to other types of Xanthomas and Xanthelasmas.

PlantarXanthoma

MRI Xanthoma on the Achilles Heel which also shows a Plantar Xanthoma

On this other client’s MRI we can see the Achilles Heel Xanthoma pressing on the tendon as on the previous case. However there is another Xanthomas growth underneath the Plantar Heel.

Given that after surgery the client will not be walking until complete healing a Xanthoma underneath the Plantar Heel should only be removed if this Xanthoma becomes particularly bothersome to the client.

Xanthoma removal from the Achilles Heel

Achilles Heel Xanthoma removal

The above picture shows a large Xanthoma removal. The surgeon might decide to perform this procedure under general anaesthetic for large Xanthomas Removal. This procedure will inevitably leave scarring to the client. However the benefits of the surgery far outweighed the small risks in this case.

Xanthomas can develop in any part of the body. Depending on were it develops it has usual characteristics. While the Xanthomas on the Achilless tendons grow underneath the dermis fortunatelly when founf on other parts of the body they decvelop between the dermis and the epidermis. This therefore allows possible Xanthoma removal without leaving any scarring.

elbow-xanthoma

Xanthoma on the elbow

As we can see in this particular case the client affected is of athletic type and does not have high cholesterol levels due to his physically active lifestyle. The Xanthomas have appeared despite of his healthy lifestyle.

Xanthomas on hands

Xanthomas on Hands

Xanthomas can also appear on the back of the hands . Removal of this type of Xanthomas is possible with lasers, Hyfrecator, Clarker and other similar equipment by superficial ablation. The operator can assess the risks of scarring depending on whether the Xanthoma has affected the dermis. As stated earlier with the exception of plantar Xanthomas (including Achilles Heels Xanthomas), Xanthomas develop superficially between the dermis and epidermis.

Normally an experienced dermatologist can assess that risk of scarring by glancing the lesion. The rule of thumb to follow in order to assess the risks of scarring, after Xanthomas removal procedures, is that the more superficial the lesion the less the risks of scarring. In case it is not possible to see the corrugation on the lesion, this means that the lesion could have grown deep into the skin and maybe underneath the dermis, but fortunately this is very rare. Therefore a deep incision is rarely required to access and remove the Xanthomas and simple superficial ablation will often suffice.

Xanthomas on Chest and Abdomen

Xanthomas on Chest and Abdomen

This case is not only a further demonstration that Xanthomas can appear anywhere on the body but also can be developed by individuals that are neither overweight nor have high cholesterol levels. The Xanthomas removal of this type of case is normally successful by simply using superficial ablation. However give the extent of the area to be treated it may require a number of sessions to achieve complete removal.

By all means it is possible to remove all Xanthomas from such a large area in a single session. The main drawback is the relatively large extent of burns that the client is subjected to within the one session. Such a large amount of burns could pose the body to needless stress which should be avoided.

xanthomas on elbowos on young client

Xanthomas on young client’s Elbows

This further example shows how Xanthomas can be developed also at a young age. The removal of this type of Xanthoma is also easy by using superficial ablation as well as specialised peelings.

Overgrown Xanthomas

Overgrown Xanthomas

Fortunately these types of cases are quite rare. This young client presented overgrown Xanthomas on the Buttocks. The best posopes removal solution would be conventional surgery under general anaesthetic. However an MRI would be advisable before scheduling surgery. The MRI will provide important information concerning these benign growth inside the client’s body.

Xanthoma on eye

Xanthoma on eye

As mentioned previously Xanthomas are benign growth but they can appear almost everywhere ion the body including the eyes.  Given the peculiarity of the Xanthoma this is a case that should be treated by an ophthalmologist. Although quite discomforting to the client this condition is not malignant and should not cause loss of vision if left untreated. Should the interocular pressure increase surgery becomes mandatory.

Gastric Xanthomas

Gastric Xanthoma

Xanthomas are not only a skin condition, grow on the the eyes etc. Xanthomas can also grow on internal organs . This is a case of Gastric Xanthoma, found by sheer chance . Of course this Xanthomas do not need to be removed as will not cause any threat

xanthoma in duodenum

Xanthoma in duodenum

This is another Xanthoma found by chance , this time on the duodenum. This benign growth is very unlikelly to grow to pose any risks to the clients (ie occlusions), therefore can be safely left untreated.

Xanthomas on Animals

Xanthomas on Animals

We thank Jeannine for this kind photo. This clearly demonstrates that Xanthomas are not a condition exclusive to us humans. Therefore if you ever develop or you have Xanthomas you know know that there little to worry. Many people have it and you may not know about it.

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