Xanthelasmas are small fatty deposits (papules or plaques) that are found just under the skin, especially around the eyes. An article by Ana Silva Guerra, specialist in Plastic, Reconstructive and Aesthetic Surgery.
The estimated prevalence is 4% with an incidence of 1.1% in women and 0.3% in men. The age of onset can range from 15 to 73 years, but the typical period of onset occurs between decades 4 and 5 of life. About half of the cases may be associated with hyperlipidemia, that is, with a change in the metabolism of lipids (cholesterol and triglycerides). The appearance of xanthelasmas before the age of 40 requires a study of hereditary changes in lipid metabolism.
The mechanism behind the appearance of these injuries is not yet fully understood. We know that it corresponds to the deposit of a specific type of fat-laden cells under the skin. The most common presentation is on the eyelids, but other places such as the neck, trunk, shoulders, and armpits can also be affected.
There is no association between the presence of xanthelasmas and HDL and triglyceride levels, however, their existence is known to be a predictor of the risk of myocardial infarction, severe atherosclerosis and eventually death.
Xanthelasmas are asymptomatic, not associated with any skin complications, and treatment is aimed at improving the appearance of the affected region.
Among the different treatment possibilities, surgery is the most common approach. Other techniques such as TCA peeling or laser can also be used, especially when the lesions are small.
Recurrence is common and can reach 60% in a second intervention. Surgery is the mainstay of treatment, especially when the lesions infiltrate the deep dermis and reach the muscle.
In conclusion, we can say that the xanthelasma of the eyelid is a lesion considered benign, but it causes significant psychological stress in the patient.
Its presence may indicate an abnormality in fat metabolism, as occurs in approximately 50% of patients, and therefore a clinical investigation should be performed.
The treatment aims to eliminate the lesions, and surgery is the method of excellence, however, recurrence can occur and the need for reoperation is common.
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