Xanthoma

	Xanthoma;
	Photograph of patient's hands showing multiple xanthoma tendinosum. Kumar et al. Cases Journal 2008
ICD-10	E78.2 (ILDS E78.280), K13.4
ICD-9	272.2
DiseasesDB	28524
MeSH	D014973

Template:Search infobox

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

A xanthoma (pl. xanthomas or xanthomata) (condition: xanthomatosis), from Greek xanthos, ξανθος, "yellow", is a deposition of yellowish cholesterol-rich material in tendons or other body parts in various disease states.^[1] They are cutaneous manifestations of lipidosis in which there is an accumulation of lipids in large foam cells within the skin.^[1]

File:Xanthoma histology.jpg

Histology picture of xanthoma showing lipid laden foam cells with large areas of cholesterol clefts, 10 × magnification, eosin and hematoxilin stain. Kumar et al. Cases Journal 2008

They are associated with hyperlipidemias, both primary and secondary types.

Tendon Xanthoma are associated with Type II hyperlipidaemia and chronic biliary obstruction.

Palmar xanthomata and tuboeruptive xanthomata (over knees and elbows) occur in Type III hyperlipidaemia

Types

Xanthelasma

A xanthelasma is a sharply demarcated yellowish collection of cholesterol underneath the skin, usually on or around the eyelids. Strictly, a xanthelasma is a distinct condition, only being called a xanthoma when becoming larger and nodular, assuming tumorous proportions.^[2] Still, it is often classified simply as a subtype of xanthoma.^[3]

Xanthoma tuberosum

Xanthoma tuberosum is characterized by xanthomas located over the joints.

Xanthoma tendinosum

Xanthoma tendinosum (also known as "Tendinous xanthoma"^[4]) is clinically characterized by papules and nodules found in the tendons of the hands.

Eruptive xanthoma

Eruptive xanthoma (ILDS E78.220) is clinically characterized by small, yellowish-orange to reddish-brown papules that appear all over the body.

Xanthoma planum

Xanthoma planum (ILDS D76.370), also known as "Plane xanthoma", is clinically characterized by macules and plaques spread diffusely over large areas of the body.

Palmar xanthoma

Palmar xanthoma is clinically characterized by yellowish plaques that involve the palms and flexural surfaces of the fingers. Plane xanthomas are characterised by yellowish to orange, flat macules or slightly elevated plaques, often with a central white area which may be localised or generalised. They often arise in the skin folds, especially the palmar creases. They occur in hyperlipoproteinaemia type III and type IIA, and in association with biliary cirrhosis. The presence of palmar xanthomata, like the presence of tendinous xanthomata, is indicative of hypercholesterolaemia.

Tuberoeruptive xanthoma

Tuberoeruptive xanthoma (ILDS E78.210) is clinically characterized by red papules and nodules that appear inflamed and tend to coalesce. Tuberous xanthomas are considered similar, and within the same disease spectrum as tuberoeruptive xanthomas.^[4]

Differential Diagnosis of Underlying Causes of Xanthoma

In alphabetical order. ^[5] ^[6]

References

↑ ^1.0 ^1.1 James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
↑ Shields, Carol; Shields, Jerry (2008). Eyelid, conjunctival, and orbital tumors: atlas and textbook. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7578-7.
↑ thefreedictionary.com > xanthelasma Citing: The American Heritage Medical Dictionary Copyright 2007, 2004 and Mosby's Medical Dictionary, 8th edition. 2009
↑ ^4.0 ^4.1 Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 1415–16. ISBN 1-4160-2999-0.
↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X