Xanthelasma is a sharply demarcated yellowish deposit of cholesterol underneath the skin.[1] It usually occurs on or around the eyelids (xanthelasma palpebrarum, abbreviated XP).[1][2] While they are neither harmful to the skin nor painful, these minor growths may be disfiguring and can be removed.[1] There is no high-quality evidence that xanthelasma deposits are related to blood low-density lipoprotein levels or increased risk of atherosclerosis.[3]

Other namesXanthelasma palpebrarum
  • /ˌzænθɪˈlæzmə/

A xanthelasma may be referred to as a xanthoma when becoming larger and nodular, assuming tumorous proportions.[4] Xanthelasma is often classified simply as a subtype of xanthoma.[5]


Xanthelasma in the form of XP can be diagnosed from clinical impression, although in some cases it may need to be distinguished (differential diagnosis) from other conditions, especially necrobiotic xanthogranuloma, syringoma, palpebral sarcoidosis, sebaceous hyperplasia, Erdheim–Chester disease, lipoid proteinosis (Urbach–Wiethe disease), and the syndrome of adult-onset asthma and periocular xanthogranuloma (AAPOX).[2] Differential diagnosis can be accomplished by surgical excision followed by microscopic examination by a pathologist (biopsy to determine histopathology).[2] The typical clinical impression of XP is soft, yellowish papules, plaques, or nodules, symmetrically distributed on the medial side of the upper eyelids; sometimes the lower eyelids are affected as well.[2]


Xanthelasmata can be removed with a trichloroacetic acid peel, surgery, lasers or cryotherapy. Removal may cause scarring and pigment changes, but it is an uncommon side-effect of treatment.


Recurrence is common: 40% of patients with XP had recurrence after primary surgical excision, 60% after secondary excision, and 80% when all four eyelids were involved. A possible cause might be insufficiently deep excisions.[2]


Xanthelasma is a rare disorder in the general population, with a variable incidence of 0.56–1.5% in western developed countries. The age of onset ranges from 15 to 75 with a peak in the 4th to 5th decades of life. There also seems to be a greater prevalence in females, but this might be due to higher consciousness to cosmetic defects.[6]


The word is derived from Greek xanthós, ξανθός , "yellow" and élasma, έλασμα, "foil". The plural is xanthelasmata.

See also


  1. Frew JW, Murrell DF, Haber RM (October 2015). "Fifty shades of yellow: a review of the xanthodermatoses". International Journal of Dermatology. 54 (10): 1109–1123. doi:10.1111/ijd.12945. PMID 26227781.
  2. Nair PA, Singhal R (2017-12-18). "Xanthelasma palpebrarum - a brief review". Clinical, Cosmetic and Investigational Dermatology. 11: 1–5. doi:10.2147/CCID.S130116. PMC 5739544. PMID 29296091.
  3. Ozdöl S, Sahin S, Tokgözoğlu L (August 2008). "Xanthelasma palpebrarum and its relation to atherosclerotic risk factors and lipoprotein (a)". International Journal of Dermatology. 47 (8): 785–9. doi:10.1111/j.1365-4632.2008.03690.x. PMID 18717856.
  4. Shields C, Shields J (2008). Eyelid, conjunctival and orbital tumors: atlas and textbook. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 978-0-7817-7578-6.
  5. Xanthelasma. Mosby's Medical Dictionary (8th ed.). 2009. Retrieved November 8, 2012.
  6. Jain A, Goyal P, Nigam PK, Gurbaksh H, Sharma RC (September 2007). "Xanthelasma Palpebrarum-clinical and biochemical profile in a tertiary care hospital of Delhi". Indian Journal of Clinical Biochemistry. 22 (2): 151–3. doi:10.1007/BF02913335. PMC 3453794. PMID 23105704.
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