Module 3B: Xanthoma

Xanthoma Tendinosum

-aka Tendon Xanthoma -a deposition of lipids into the macrophages of the skin overlying tendons or ligaments.

Eruptive Xanthomas locations

Appear suddenly all over the body, especially the hands, buttocks, and the extensor surfaces of the extremities.

Xanthoma Tuberosum are associated with...

Familial hypercholesterolemia and familial dysbetalipoprotinemia

Xanthoma Planum is associated with...

They are associated with primary and secondary hyperlipidemias, especially hypertriglyceridemia. Also in monoclonal gammopathy.

Xanthoma Tuberosum are located

Usually located over joints or extensor surfaces of the extremities (elbows and knees)

subtype of xanthoma provides...

a clue to the underlying lipid abnormality

Eruptive Xanthomas commonly confused with...

dermatological conditions such as molluscum contagiosum

Xanthoma Tendinosum is associated

familial hypercholesterolemia

Xanthoma

localized lipid deposits

Xanthoma Tendinosum characteristics

papules and nodules found in the tendons of the hands, feet, heel, and overlying the Achilles tendon

Xanthomas may manifest as...

papules, plaques, or nodules in skin

Eruptive Xanthomas characteristics

small yellow- orange papules or may be red-brown papules and often have an erythematous hue at the base

Xanthoma Tuberosum (Tuberous Xanthomas)

yellow-orange or erythematous papules or nodules

Palmar Xanthoma characteristics

yellowish to orange flat macules or slightly elevated plaques which often with a central white area

Eruptive Xanthomas are associated with...

• Eruptive xanthomas may be due to a primary hyperlipoproteinemia resulting from a genetic deficiency of lipoprotein lipase (Type 1 hyperlipoproteinemia) or familial hyperlipoproteinemia (Type V) • May be associated with elevated triglycerides, or may be found in patients unresponsive to insulin

Palmar Xanthoma location

• Involve the palms and flexural surfaces of the fingers • They often arise in the skin folds, especially the palmar creases • May be localized or generalized

Xanthoma Planum located

• They can occur over the entire body, and are very large. • Preferred localizations are the face, the neck, the thorax, the armpits and the groins and other folds.

Palmar Xanthoma are associated

• They occur in hyperlipoproteinaemia type III & type IIA, & in association with biliary cirrhosis. • The presence of palmar xanthomata, like the presence of tendinous xanthomata, is indicative of hypercholesterolaemia

Types of Xanthoma

• Xanthelasma • Xanthoma Planum • Xanthoma Tuberosum • Xanthoma Tendinosum • Palmar Xanthoma • Eruptive Xanthoma

Xanthoma Planum appear...

• aka plane xanthoma • Clinically characterized by macules and plaques spread diffusely over large areas of the body • Macules may be yellowish or brown in color • May be slightly elevated

Xanthelasma appear...

• flat or mildly elevated plaques found on the upper or lower eyelids, most often near the inner part of the eye. • Not harmful or painful • Can be surgically removed • This does not diagnose high cholesterol, but is commonly found in all versions of hyperlipidemia • Typically is called a xanthoma when it becomes larger and nodular, but it is often classified simply as a subtype of xanthoma