Cardiovascular Profile of Xanthelasma Palpebrarum

Abstract

Xanthelasma palpebrarum (XP) are yellow plaques that occur most commonly near the inner canthus of the eyelid and are often associated with atherosclerosis, dyslipidemia, and coronary artery disease. This study was planned to address the issue of associated cardiovascular morbidity in xanthelasma patients attending our cardiac clinic. Materials and Methods. A total of 61 patients were detected to be having xanthelasma and constituted the study group. The control group constituted of 130 apparently normal individuals. Each patient underwent detailed history, examination, and investigations. Results and Discussion. The most prevalent age group was 40 to 60 years. Males outnumbered females. A percentage of 39.3% of cases had concomitant nicotine addiction. Dyslipidemia was present in 60% of cases, hypertension in 37.7%, prehypertension in 8.77%, diabetes mellitus in 18.03%, and prediabetes in 26.3%. Smokers and obese patients with xanthelasma had a higher prevalence of hypertension. Coronary artery disease (CAD) was found in 6.56% of XP cases. The waist circumference and diastolic blood pressures were significantly higher in XP patients. Conclusion. A significant number of cases of xanthelasma palpebrarum are combined with smoking, central obesity, hypertension, diabetes mellitus, and dyslipidemia which are the major risk factors for CAD. Efforts should be made to rule out the same in high-risk xanthelasma subjects.

The Significance of Extracellular Cholesterol Crystals or a Cholesterol Granuloma in Xanthelasma

“…In an earlier review, it was determined that half of the patients with xanthelasma had normal serum lipid levels and half manifested lipid dysregulation; there were no distinguishing microscopic findings between the two groups [20]. In another series, 7% of patients with xanthelasma had coronary artery disease [21]. Xanthelasma has been studied as a marker of premature atherosclerosis by discovering ultrasonographic thickening of the carotid intima [22].…”

The clinical spectrum of xanthomatous lesions of the eyelids

“…a) or xanthoma tendinosum . It has been advised that all patients with XP should be investigated for serum lipid profile as well as for other major risk factors of coronary artery disease …”

“…Several types of cutaneous xanthomas have been described. Xanthelasma palpebrarum (XP) is the well‐known type of xanthomas occurring as yellowish lesions on the eyelids, often causing a cosmetic problem . It may represent a localized idiopathic cutaneous phenomenon or may be a sign of systemic hyperlipidemia of varying degree .…”

“…2,3 It may represent a localized idiopathic cutaneous phenomenon or may be a sign of systemic hyperlipidemia of varying degree. 2 However, there are many other rare diseases causing similar appearance on the eyelids without affecting the lipid metabolism (normolipidemic disorders), 4 most of them classified in the group of histiocytoses. There is no consensus in the literature how to describe these eyelid lesions, but we prefer the term "xanthomatous" to describe a yellowish to orange-colored patch, papule, nodule, or plaque on this area.…”

Association of Xanthelasma palpebrarum (XP) with cardiovascular disease (CVD) risk factors

“…XP most commonly occurs in the fourth and fifth decade of individual life. According to many previously conducted epidemiological studies, XP is highly associated with atherosclerosis, cardiovascular disease, diabetes, obesity and pancreatitis (Dey, Aggarwal, & Dwivedi, 2013;Pandhi et al, 2012). A number of previously conducted research also identified increased biochemical lipid profiles for patients with XP such as, higher level of LDL and VLDL cholesterol and lower level of HDL cholesterol which are established predictors of cardiovascular diseases (Kavoussi et al, 2016).…”