In my last article, the description of eruptive xanthoma, xanthelasma palpebrarum, tuberous xanthoma, tendinous xanthoma, and eruptive xanthoma were explained. Now, we will continue looking at the other xanthomas caused by hyperlipidemia.
Tuberous xanthomas: These are red-yellow, firm nodules that develop on the extensor surface of the knees, buttocks, and elbow (2). Over time, these xanthomas can form multilobated tumors (1).
Plane xanthomas: These xanthomas can appear on any part of the skin, are macular but generally not elevated (2). Generalized plane xanthomas can cover large regions of the body, including the face and neck. Development of palmar creases in plane xanthomas indicates type III dysbetalipoproteinemia.
There are two other forms of xanthoma, xanthoma disseminatum and verruciform xanthoma not associated with hyperlipidemia. Xanthoma disseminatum appears as red-yellow papules and nodules in adults (2). Verruciform xanthomas are generally single papillomatous yellow lesions in the mouth.
Xanthomas associated with hyperlipidemia require treatment of the lipid disorder to reduce the xanthomas and prevent possible risks (such as atherosclerosis) (2). Hyperlipidemia can be treated by proper diet, which will be recommended by a dietitian. In addition to diet change, the use of lipid-lowering compounds, such as fibrates, probucol, and nicotinic acid, may be recommended to treat hyperlipidemia. These treatments may not directly resolve xanthoma, but treatment of hyperlipidemia may resolve or lessen the issue.
Some xanthomas, such as eruptive xanthoma and tuberous xanthomas may disappear after systemic treatment, while other such as tendinous xanthomas, will not. In some cases, treatment with lipid-lowering compounds is enough to decrease or eliminate the xanthomas and prevent further complications, such as atherosclerosis. For those that are not, surgical methods may be employed. Treatment of xanthelasmas with electrodesiccation, laser therapy, or excision have proven effective (2). However, surgical methods may not be a permanent treatment, as reoccurrence rates for xanthomas depend on the underlying issues.