Treatment of xanthelasma palpebrarum with intralesional heparin sodium: a pilot study

Azendour, Hasna; Alami, Sofia; Meziane, Mariame; Ismaïli, Nadia; Benzekri, Laïla; Senouci, Karima

doi:10.1111/ijd.16509

Cited by 3 publications

(6 citation statements)

References 3 publications

(8 reference statements)

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“…6,7 Heparin sodium is an anticoagulant medication that was recently re-advised as a hopeful therapeutic option for xanthelasma. 10,11 The present study showed that 56.7% of the patients had elevated cholesterol levels which is in agreement with previously published researches. [17][18][19] Cholesterol accumulation in foam histiocytes may be due to enhanced uptake in addition to impaired removal of cholesterol from the lesions, with resultant activation of inflammatory mediators in xanthomatous lesions in a manner similar to atherogenesis.…”

Section: Discussionsupporting

confidence: 93%

“…Interestingly, the current study detected excellent improvement in 66.7% of xanthelasma patients following intradermal heparin sodium injection. These results were in agreement with previous studies done by Ren et al, 10 and Azendour et al 11 They explained their promising results by the possibility that heparin sodium injection in xanthmatous lesions could trigger accumulation and activation of the lipoprotein lipase with subsequent reduction of abnormal lipoproteins deposition in peripheral tissues 10,11 …”

Section: Discussionsupporting

confidence: 92%

“…The CO 2 laser beam (10,600 nm wavelength) is selectively absorbed by extracellular fluid with subsequent vaporization and coagulation of xanthelasma lesions 6,7 . Heparin sodium is an anticoagulant medication that was recently re‐advised as a hopeful therapeutic option for xanthelasma 10,11 …”

Section: Discussionmentioning

confidence: 99%

“…Therefore, Cornbleet 9 suggested it as a promising treatment option for xanthomas since 1955. However, this approach was neglected for several decades, and in the last decade, two former studies assessed the efficacy of intradermal injection of heparin sodium in the treatment of xanthelasma and reported successful results 10,11 …”

Section: Introductionmentioning

confidence: 99%

“…However, this approach was neglected for several decades, and in the last decade, two former studies assessed the efficacy of intradermal injection of heparin sodium in the treatment of xanthelasma and reported successful results. 10,11 Hence, this work was designed to analyze the therapeutic outcomes of ablative CO 2 laser versus intradermal injection of heparin sodium in xanthelasma lesions. Following informed consent, clinical and dermoscopic assessments of xanthelasma lesions (number, size, site, and extent) were done to define the xanthelasma grading as follows 12 : Grade (Ι), if xanthelasma lesions were limited to the upper palpebral region; Grade (ΙΙ), if xanthelasma lesions were spread to the medial eye canthus; Grade (ΙΙΙ), if xanthelasma lesions were developed on the medial aspects of both upper and lower palpebral regions; and Grade (IV), if xanthelasma lesions were developed on both the medial and lateral aspects of the upper and lower palpebral regions.…”

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confidence: 99%

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Clinical and dermoscopic assessment of ablative carbon dioxide laser versus intradermal heparin sodium in xanthelasma

Neinaa,

Awara,

Shalaby

et al. 2023

Photoderm Photoimm Photomed

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BackgroundAblative carbon dioxide (CO2) laser is still a cornerstone in the management of xanthelasma. However, post‐laser complications such as post‐inflammatory hyperpigmentation or scarring have to be considered. Heparin sodium was recently suggested as an effective therapeutic modality for xanthelasma.ObjectiveThe aim of this work was to compare the therapeutic value of ablative CO2 laser versus intradermal heparin sodium in xanthelasma.MethodsThis study was piloted on 30 xanthelasma patients, whose lesions were randomly categorized into two groups. Group A was managed with CO2 laser ablation (2 sessions scheduled every 4 weeks), whereas Group B was managed with intradermal heparin sodium injections (10 sessions scheduled every week). Pre‐ and post‐treatments evaluations were done both clinically and dermoscopically.ResultsSignificant reduction of xanthelasma lesions was reported in response to both therapeutic interventions. However, the ablative CO2 laser was more significantly effective than intradermal heparin sodium. Interestingly, intradermal injection of heparin sodium was nearly as effective as ablative CO2 laser in early (<2 years duration) grade I and II xanthelasma, with a lower incidence of post‐therapy side effects.ConclusionsIntradermal injection of heparin sodium could be suggested as a safe and cost‐effective therapeutic technique for early mild grade I and II xanthelasma. Moreover, it could be recommended as a pre‐operative management of grade III and IV xanthelasma to reduce the lesions to be easily ablated with CO2 laser.

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