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XANTHOMAS

A Xanthoma is the deposition of a yellowish material anywhere on the body, but is mostly found on the knees, elbows, feet and hands. This material is cholesterol rich and can emerge underneath the skin during a range of diseases. They usually occur when the levels of fats are high in the body. They appear like orange or yellow coloured flattened bumps on the surface of the skin and vary in size. They can be as small as a tiny speck or as big as the size of a grape. They are diagnosed easily by a skin examination; however, a biopsy is done to confirm the presence of the fatty material that causes xanthomas. Blood tests are also required to check levels of fats, to gauge the functioning of the liver and to confirm if the patient is diabetic.

Types of xanthomas –

  1. Xanthelasma – They usually occur on or around the eyelids. It appears as a clearly demarcated yellowish cholesterol collection underneath the skin.
  2. Xanthoma tuberosum – These grow underneath the skin of the joints.
  3. Eruptive Xanthoma – These occur as the levels of triglycerides increase. They appear small and are yellow, orange or reddish brown in colour. They usually grow all over the body.
  4. Palmer xanthoma – they appear on the palms and finger surfaces especially in the folds of the skin. They are yellowish in colour with the centre appearing white, are flat and slightly elevated.

Causes of xanthomas are varied. Because they occur when the levels of fats are high in the body, they are commonly diagnosed on patients suffering from high blood cholesterol and diabetes. Some more medical conditions that may be a cause of xanthomas are elaborated below for your understanding.

  1. Hypothyroidism – Here the thyroid doesn’t produce hormones in a normal way.
  2. Primary biliary cirrhosis - Patients diagnosed with primary biliary cirrhosis are at a risk of developing xanthomas as the bile ducts in the liver are gradually damaged or destroyed.
  3. Cholestasis – This is a medical condition wherein the flow of bile from the liver slows down or stops completely.
  4. Nephrotic syndrome – This syndrome damages the blood vessels in the kidneys.
  5. Genetic conditions – Genetic conditions like hematologic disease that affect the body’s ability to digest fats.
  6. Cancer – The growth of cancerous cells at uncontrolled rate can also lead to xanthomas.
  7. Side effects – Occurrence of xanthomas could be a side effect of medication such as cyclosporine.
  8. Hyperlipidemia – heightened levels of lipoproteins in the body.

If one the medical conditions mentioned above is known, xanthomas can be treated by treating the condition. Controlling the levels of fats is the only way to ensure less chances of developing xanthomas. However, in case the underlying cause is not known, the xanthomas can be treated or removed with the help of a surgery, laser therapy or a chemical treatment. Patients are requested to note that since the underlying medical condition hasn’t been diagnosed, xanthomas might reoccur. Hence, we encourage our patients to talk to us to get the relevant tests done. Once the underlying medical condition is cured and the blood cholesterol and lipid levels are controlled, patients can get rid of xanthomas.

Authored By Dr. Harish Prasad

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