General information
If xanthelasma or xanthomas occur in patients, this is due to a disturbance in the fat metabolism of the affected persons. During the digestive process, the body absorbs too much fat from the food it consumes instead of excreting the excess fat. The body then stores this fat as tiny fat nodules in the skin. In the so-called xanthoma, the fats are encapsulated as lipids (cholesterol) in the skin cells (histiocytes). Xanthelasma is a special form of xanthoma: the body stores the lipids in the cells of the eyelids (macrophages, foam cells), so that the occurrence is particularly noticeable in these areas.
Shapes of Xanthelasma
There are different forms of xanthomas and xanthelasmas. For example, a distinction is made between deposits of fat that a patient has despite normal blood lipid values (normolipidaemic xanthomas and xanthelasmas) and deposits in patients with excessive blood lipid values (hyperlipidaemic xanthomas and xanthelasmas). In addition, there are also deposits caused by other existing diseases, such as diabetes, pancreatitis or alcoholic liver diseases (so-called secondary xanthomas or xanthelasmas). According to the current state of science, the deposition of fat is not related to the weight of the affected patients, because even people of normal weight can get xanthomas or xanthelasmas. A family history of xanthelasma on the eyelids is conspicuous, so a genetic influence is being considered.
Occurrence of xanthelasma
The so-called xanthelasma palpebarum usually occurs from the age of 50, but is also observed from the age of 40. Xanthomas are most often formed over the elbows and knee joints, on the buttocks or tendon sheaths and show up as nodules that are not painful. The color of the nodules is yellowish due to the embedded fat, but the skin above is inconspicuous. If many of the yellowish nodules develop within a short period of time, the medical term is eruptive xanthomas.
Further influences
Currently, a presumably considerable influence of lifestyle on the development of xanthomas and xanthelasms is being discussed. It is assumed that smoking, lack of exercise, lack of sleep, stress and an unbalanced “western” diet considerably increase the occurrence of xanthomas and/or xanthelasma and that they can be precursors of stroke and heart attack. For this reason, the nodules should be shown to the family doctor and a possibility should be worked out together to positively influence the lifestyle itself in addition to a drug treatment of the basic ailments (e.g. diabetes, lipid metabolism disorder), so that the health of the whole organism is promoted and a new occurrence of xanthomas, xanthelasmas or serious harmful health events can be avoided.