Outcomes of Surgical Management of Xanthelasma Palpebrarum

Abstract

BackgroundXanthelasma palpebrarum (XP) is a benign disorder manifesting as yellowish cholesterol-laden plaques on the eyelids. This paper presents the outcomes in patients with XP who have undergone surgical excision as the main modality of treatment.MethodsA retrospective review of patients who received surgery for xanthelasma palpebrarum from March 2007 to March 2011 was conducted. Patients were classified into four grades according to the location and extent of the lesion, with grade I being the mildest and grade IV being the most diffuse. Simple excision was performed in grade I and II lesions, while local flaps and skin grafts were performed in the more advanced grades.ResultsNinety-five cases from March 2007 to March 2011 were included in this study. 66 cases (70%), were treated by simple excision. Twenty-four cases (25%) and 5 cases (5%) were treated by simple excision in combination with or without local flaps and skin grafts. In approximately 1/4 of the patients, orbicularis oris muscle involvement was observed. 4 patients (4.2%) developed scar contracture postoperatively, which required a secondary procedure. Recurrence was reported in 3 patients (3.1%). Otherwise. There were no other reports of major complications or disfigurement.ConclusionsWe found that for lesions involving the deep dermis and/or muscle, surgical excision was the most appropriate therapeutic option.

Serum lipid profile and clinical characteristics of patients with xanthelasma palpebrarum

“…16 This finding is compatible with the results of our study in that more than half of the patients underwenta slight extension of xanthematous lesions.…”

Treatment of Grade I and II types of xanthelasma palpebrarum with intralesional heparin sodium

“…The histologic feature of xanthelasma is similar to atherosclerotic plaques, and xanthelasma has been recognized as an extrinsic manifestation of dyslipidoses (Ribera et al, ). Xanthelasma can be classified into four grades by clinical manifestation and invasion range of the lesions: Grade I, the lesions involve only the upper eyelids; Grade II, the lesions extend to the medial canthal area; Grade III, the lesions involve the medial side of the upper and lower eyelids; Grade IV, the lesions diffusely involve the medial and lateral sides of the upper and lower eyelids (Lee, Jin, Minn, & Park, ). Grade I and II types of xanthelasma are more commonly seen.…”

Erbium:Yttrium Aluminum Garnet Laser Treatment for Xanthelasma Palpebrarum

“…However, upper blepharoplasty may be needed for a drooping eyelid. 4 If a defect is large after removal of a xanthelasma, a skin graft is occasionally performed. However, this is not recommended on the upper eyelid, because grafted skin on a mobile tissue can wrinkle easily.…”

“…Various treatment options for xanthelasma palpebrarum are available, including surgical excision, 4,5 chemical peeling, 6,7 cryotherapy, argon laser, 8 carbon dioxide (CO2) laser, 9,10 and neodymium:yttrium aluminum garnet (Nd:YAG) laser. 11,12 However, the results thereof are generally suboptimal and involve high recurrence rates.…”