Xanthoma

See also: Xanthelasma

Xanthoma

Photograph of patient's knee showing multiple

xanthoma tuberosum [1]
Classification and external resources
Specialty

gastroenterology

ICD-10

E78.2 (ILDS E78.280), K13.4

ICD-9-CM

272.2

DiseasesDB

28524

MedlinePlus

001447

eMedicine

derm/461

MeSH

D014973

A xanthoma (pl. xanthomas or xanthomata) (condition: xanthomatosis), from Greek xanthos,

, "yellow", is a deposition of yellowish cholesterol-rich material that can appear anywhere
in the body in various disease states.[2] They are cutaneous manifestations of lipidosis in which
lipids accumulate in large foam cells within the skin.[2] They are associated with hyperlipidemias,
both primary and secondary types.
Tendon xanthomas are associated with type II hyperlipidemia, chronic biliary tract obstruction,
and primary biliary cirrhosis. Palmar xanthomata and tuboeruptive xanthomata (over knees and
elbows) occur in type III hyperlipidemia.

Contents

1 Types
o 1.1 Xanthelasma
o 1.2 Xanthoma tuberosum
o 1.3 Xanthoma tendinosum
o 1.4 Eruptive xanthoma
o 1.5 Xanthoma planum
o 1.6 Palmar xanthoma
o 1.7 Tuberoeruptive xanthoma
o 1.8 Other types

2 See also

3 References

4 External links

Types
Xanthelasma
Main article: Xanthelasma

Histology picture of xanthoma showing lipid-laden foam cells with large areas of cholesterol
clefts, 10 magnification, eosin and hematoxilin stain[3]
A xanthelasma is a sharply demarcated yellowish collection of cholesterol underneath the skin,
usually on or around the eyelids. Strictly, a xanthelasma is a distinct condition, only being called

a xanthoma when becoming larger and nodular, assuming tumorous proportions.[4] Still, it is
often classified simply as a subtype of xanthoma.[5]
Xanthoma tuberosum
Xanthoma tuberosum (also known as tuberous xanthoma) is characterized by xanthomas located
over the joints.[2]:530
Xanthoma tendinosum
Xanthoma tendinosum (also tendon xanthoma or tendinous xanthoma[6]) is clinically
characterized by papules and nodules found in the tendons of the hands, feet, and heel.[2]:531 Also
associated with familial hypercholesterolemia (FH).[7]

Eruptive xanthoma
Eruptive xanthoma (ILDS E78.220) is clinically characterized by small, yellowish-orange to
reddish-brown papules that appear all over the body.[2]:531 It tends to be associated with elevated
triglycerides [8]
Xanthoma planum
Xanthoma planum (ILDS D76.370), also known as plane xanthoma, is clinically characterized
by macules and plaques spread diffusely over large areas of the body.[2]:531
Palmar xanthoma
Palmar xanthoma is clinically characterized by yellowish plaques that involve the palms and
flexural surfaces of the fingers.[2]:531 Plane xanthomas are characterised by yellowish to orange,
flat macules or slightly elevated plaques, often with a central white area which may be localised
or generalised. They often arise in the skin folds, especially the palmar creases. They occur in
hyperlipoproteinaemia type III and type IIA, and in association with biliary cirrhosis. The
presence of palmar xanthomata, like the presence of tendinous xanthomata, is indicative of
hypercholesterolaemia.
Tuberoeruptive xanthoma
Tuberoeruptive xanthoma (ILDS E78.210) is clinically characterized by red papules and nodules
that appear inflamed and tend to coalesce.[2]:532 Tuberous xanthomata are considered similar, and
within the same disease spectrum as eruptive xanthomata.[6]
Other types
Other types of xanthoma identified in the Medical Dictionary include:[9]

eruptive x.: usually appearing on the back and buttocks, or the extensors of knees and
elbows of hyperlipemic individuals, it is the sudden appearance of groups of yellowishbrown papules surrounded by an erythematous halo.

x. diabeticorum: a type of eruptive xanthoma, often with severe diabetes.

x. disseminatum: a rare xanthoma, consisting of non-X histiocytes on flexural surfaces,

associated with diabetes insipidus.

x. planum: yellow bands or rectangular plates in the corium.

verrucous x.: aka histocytosis Y, a papilloma of the oral mucosa and skin, whereby the
connective tissue under the epithelium contains histiocytes.

See also

Xanthelasma

List of xanthoma variants associated with hyperlipoproteinemia subtypes

References
1. Kumar et al. Cases Journal 2008
2. James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin:
clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
3. Kumar et al. Cases Journal 2008
4. Shields, Carol; Shields, Jerry (2008). Eyelid, conjunctival, and orbital tumors: atlas and
textbook. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7578-7.
5. thefreedictionary.com > xanthelasma Citing: The American Heritage Medical Dictionary
Copyright 2007, 2004 and Mosby's Medical Dictionary, 8th edition. 2009
6. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume
Set. St.
7. van den Bosch, Harrie C.M.; Vos, Louwerens D. (1998). "Achilles'-Tendon Xanthoma in
Familial Hypercholesterolemia". New England Journal of Medicine 338 (22): 1591
1591. doi:10.1056/NEJM199805283382205. ISSN 0028-4793. PMID 9603797.
8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3030216/
9. "Xanthoma". Medical Dictionary - Dictionary of Medicine and Human Biology.
Retrieved 2015-02-05.
10.