Xanthoma

Also known as xanthelasma

Xanthoma are small fatty lumps under the surface of the skin.

Xanthomas are common, especially among older adults and people with high blood lipids. They vary in size, shape and thickness and can appear anywhere, but the most common areas are upper eyelids, elbows, tendons, over joints and knees.

Types of xanthoma

  • Xanthelasma palpebrum is the most common type, upper or lower eyelid, soft, white/yellow, flat papules or plaques.
  • Eruptive xanthomas, which are crops of small, red-yellow papules over buttocks, limbs, these may go away over a few weeks.
  • Tendinous xanthomas
    • Subcutaneous nodules related to the tendons or ligaments (hands, achilles tendon, feet etc).
    • Associated with severe hypercholesterolaemia and elevated LDL levels.
  • Tuberous xanthomas
    • These are firm, painless, red to yellow coloured nodules that appear over pressure areas such as the knees, elbows, heels and buttocks.
    • Often associated with high cholesterol levels.
  • Diffuse plane xanthomatosis - flat papules or patches that can occur anywhere on the body.

Symptoms

Xanthoma are generally non tender white or yellow lumps found on different parts of the body. They may be a sign of an underlying lipid or metabolic problem that leads to an increase in blood lipids or storage.

Such conditions include:

  • hyperlipidemia
  • certain cancers
  • diabetes
  • inherited metabolic disorders such as familial hypercholesterolemia
  • hypothyroidism
  • primary biliary cirrhosis
  • pancreatitis.

Diagnosis

If you think you may have a xanthoma appearing, show your doctor as it can be a pointer to other problems. You may need to have a blood test to check for lipid disorders, liver function, thyroid problems and diabetes.

Treatment

Treatment options include:

  • Treating any underlying lipid disorders with diet and medications (if recommended). This can reduce their size and prevent new ones appearing.
  • Topical trichloroacetic acid.
  • Electrodesiccation.
  • Laser vaporization.
  • Surgical removal (it can come back or new ones can appear if the underlying lipid problems are not treated).
  • Leave them alone - the growths are painless and treatment is for visual or cosmetic benefit only.

Prevention

Keeping your blood lipids within a normal range through healthy eating and maintaining a healthy weight can help. If family members have xanthoma, go and see your doctor for a lipid test in case there is a familial (genetic) lipid disorder in your family.

Learn more

Xanthomas - types, causes and treatment DermNet NZ

Credits: Written by Health Navigator NZ. Last reviewed: 01 Apr 2014