The FP recognized the yellow papules on the patient’s eyelids as xanthelasma (xanthoma palpebrarum). Xanthelasma is most often seen on the medial aspect of the eyelids; the upper lids are more often affected than are the lower lids. Fifty percent of patients with xanthelasmas have normal lipid profiles.
Xanthelasma lesions may be treated for cosmetic purposes. Methods include surgery, electrosurgery, cryotherapy, and laser therapy.
In this case, the FP counseled the patient to take her lipid-lowering medication, explaining that her xanthelasma was a visible sign of her elevated cholesterol. The patient didn’t want to pursue cosmetic treatment for the xanthelasma, but said she’d be willing to take her lipid-lowering medication regularly. The physician also told her he wanted to have her fasting lipid profile measured in a month.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Smith M. Xanthomas. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:951-953.
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