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Xanthoma


Source: http://en.wikipedia.org/wiki/Xanthoma
Updated: 2017-05-27T22:32Z
Xanthoma
Xanthoma.jpg
Photograph of patient's knee showing multiple xanthoma tuberosum[1]
Classification and external resources
Specialty{{#statements:P1995}}
ICD-10E78.2 (ILDS E78.280), K13.4
ICD-9-CM272.2
DiseasesDB28524
MedlinePlus001447
eMedicinederm/461
Patient UKXanthoma
MeSHD014973
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A xanthoma (pl. xanthomas or xanthomata) (condition: xanthomatosis), from Greek ξανθος (xanthos), meaning 'yellow', is a deposition of yellowish cholesterol-rich material that can appear anywhere in the body in various disease states.[2] They are cutaneous manifestations of lipidosis in which lipids accumulate in large foam cells within the skin.[2] They are associated with hyperlipidemias, both primary and secondary types.

Tendon xanthomas are associated with type II hyperlipidemia, chronic biliary tract obstruction, and primary biliary cirrhosis. Palmar xanthomata and tuboeruptive xanthomata (over knees and elbows) occur in type III hyperlipidemia.

Types

Xanthelasma

Histology picture of xanthoma showing lipid-laden foam cells with large areas of cholesterol clefts, 10 × magnification, eosin and hematoxilin stain[1]

A xanthelasma is a sharply demarcated yellowish collection of cholesterol underneath the skin, usually on or around the eyelids. Strictly, a xanthelasma is a distinct condition, only being called a xanthoma when becoming larger and nodular, assuming tumorous proportions.[3] Still, it is often classified simply as a subtype of xanthoma.[4]

Xanthoma tuberosum

Xanthoma tuberosum (also known as tuberous xanthoma) is characterized by xanthomas located over the joints.[2]:530

Xanthoma tendinosum

Xanthoma tendinosum (also tendon xanthoma or tendinous xanthoma[5]) is clinically characterized by papules and nodules found in the tendons of the hands, feet, and heel.[2]:531 Also associated with familial hypercholesterolemia (FH).[6]

Eruptive xanthoma

Eruptive xanthoma (ILDS E78.220) is clinically characterized by small, yellowish-orange to reddish-brown papules that appear all over the body.[2]:531 It tends to be associated with elevated triglycerides [7]

Xanthoma planum

Xanthoma planum (ILDS D76.370), also known as plane xanthoma, is clinically characterized by macules and plaques spread diffusely over large areas of the body.[2]:531

Palmar xanthoma

Palmar xanthoma is clinically characterized by yellowish plaques that involve the palms and flexural surfaces of the fingers.[2]:531 Plane xanthomas are characterised by yellowish to orange, flat macules or slightly elevated plaques, often with a central white area which may be localised or generalised. They often arise in the skin folds, especially the palmar creases. They occur in hyperlipoproteinaemia type III and type IIA, and in association with biliary cirrhosis. The presence of palmar xanthomata, like the presence of tendinous xanthomata, is indicative of hypercholesterolaemia.

Tuberoeruptive xanthoma

Tuberoeruptive xanthoma (ILDS E78.210) is clinically characterized by red papules and nodules that appear inflamed and tend to coalesce.[2]:532 Tuberous xanthomata are considered similar, and within the same disease spectrum as eruptive xanthomata.[5]

Other types

Other types of xanthoma identified in the Medical Dictionary include:[8]

  • eruptive x.: usually appearing on the back and buttocks, or the extensors of knees and elbows of hyperlipemic individuals, it is the sudden appearance of groups of yellowish-brown papules surrounded by an erythematous halo.
  • x. diabeticorum: a type of eruptive xanthoma, often with severe diabetes.
  • x. disseminatum: a rare xanthoma, consisting of non-X histiocytes on flexural surfaces, associated with diabetes insipidus.
  • x. planum: yellow bands or rectangular plates in the corium.
  • verrucous x.: aka histocytosis Y, a papilloma of the oral mucosa and skin, whereby the connective tissue under the epithelium contains histiocytes.

See also

References

  1. ^ a b Kumar et al. Cases Journal 2008
  2. ^ a b c d e f g h James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
  3. ^ Shields, Carol; Shields, Jerry (2008). Eyelid, conjunctival, and orbital tumors: atlas and textbook. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7578-7. 
  4. ^ thefreedictionary.com > xanthelasma Citing: The American Heritage Medical Dictionary Copyright 2007, 2004 and Mosby's Medical Dictionary, 8th edition. 2009
  5. ^ a b Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 1415–16. ISBN 1-4160-2999-0. 
  6. ^ van den Bosch, Harrie C.M.; Vos, Louwerens D. (1998). "Achilles'-Tendon Xanthoma in Familial Hypercholesterolemia". New England Journal of Medicine. 338 (22): 1591–1591. ISSN 0028-4793. PMID 9603797. doi:10.1056/NEJM199805283382205. 
  7. ^ Digby M; Belli R; McGraw T; Lee A (2011). "Eruptive xanthomas as a cutaneous manifestation of hypertriglyceridemia: a case report". J Clin Aesthet Dermatol. 4: 44–6. PMC 3030216Freely accessible. PMID 21278899. 
  8. ^ "Xanthoma". Medical Dictionary - Dictionary of Medicine and Human Biology. Retrieved 2015-02-05. 

External links

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