Xanthomas

Cutaneous xanthomas result from the localized accumulation of lipid within the dermis or connective tissue. They can present anywhere on the body with a variety of morphologies ranging from discrete macules and papules to nodules and diffuse plaques, typically with a yellow-to-orange color due to the lipid deposition. In darker skin types, however, the lesions may appear more red-to-brown in color. Xanthomas are most commonly associated with hyperlipemic states, which may be due to primary genetic causes or secondary to other metabolic derangements. Less frequently, normolipemic xanthomas have been reported in association with monoclonal gammopathies or without any associated underlying disease. The major subtypes of xanthomas associated with disorders of lipid metabolism include tuberous, tendinous, eruptive, planar, and palmar. Xanthelasmas, a type of planar xanthoma, may or may not be associated with a hyperlipidemia. Prompt recognition and early diagnosis of the lesions can significantly aid in the management and prognosis of any potential underlying disease as cutaneous lesions may sometimes precede any systemic signs of symptoms. Moreover, the morphology and distribution of the xanthomas can suggest a particular lipoproteinemia or another systemic disease.