Xanthelasma palpebrarum (XP) are small xanthomas formed on the eyelids by small groups of macrophages containing lipid in their cytoplasm.

Appearance: small papules and/or small plaques.

Color: yellow, orange, reddish or flesh-colored.

Number: few to many

Usual location: medial aspect of the upper eyelid near the inner canthus


Possible causes:

(1) familial hyperlipidemia

(2) acquired hyperlipidemia (hypothyroidism, diabetes, cholestatic liver disease, etc)

(3) drug effect (nilotinib, other)

(4) sitosterolemia

(5) allergic contact dermatitis

(6) idiopathic with normolipemia


Clinical features suggesting an underlying hyperlipidemia:

(1) arcus senilis

(2) xanthomas elsewhere

(3) history of coronary artery disease

(4) early onset

(5) other history (familial hyperlipidemia, disorder associated with acquired hyperlipidemia)


Differential diagnosis:

(1) migration of injected cosmetic filler

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