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Skin xanthomas: causes, symptoms, diagnosis, treatment
Last reviewed: 04.07.2025
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Tuberous xanthomas (synonyms: multiple xanthoma, primary hypercholesterolemic xanthomatosis).
Skin xanthomas, in particular multiple tuberous xanthomas, are one of the manifestations of impaired lipid metabolism.
Causes skin xanthoma
Increased levels of triglycerides and cholesterol in blood plasma due to disturbances in the formation, transport and breakdown of lipoproteins have been identified. Clinically, eruptive, tuberous, tendinous and flat xanthomas are distinguished.
Symptoms skin xanthoma
Multiple tuberous xanthoma is characterized by the presence of symmetrically located nodular tumor-like formations of a yellowish or brown color, dense consistency, the size of a large pea to a walnut, fused into a conglomerate. A reddish-bluish border may be observed around the elements. Subjective sensations are not noted. The elements are localized mainly in the area of large joints - knees and elbows, as well as on the buttocks, shoulders, back of the fingers, facial skin, and scalp. Diascopy reveals a characteristic yellowish background of the foci. Tuberous xanthoma is combined with other types of xanthomas and can be combined with pathology of internal organs (atherosclerosis of the heart vessels, nephrosclerosis).
Histopathology
Hyperkeratosis is observed in the epidermis, it has a normal thickness. In the reticular layer of the dermis, infiltrates are observed, consisting of lymphocytes, foamy mono- or multinuclear giant cells.
What do need to examine?
How to examine?
Differential diagnosis
The disease should be distinguished from lipoma, eruptive xanthoma, rheumatoid nodules.
Treatment skin xanthoma
Firstly, dairy and vegetable food, limitation of fat intake are recommended. At the same time, normalization of disturbed lipid metabolism and visceral disorders is necessary. Surgical removal of large nodes and tumors, diathermocoagulation of small formations are used.
Eruptive xanthomas
Synonyms: papuloeruptive xanthoma, multiple nodular xanthomas
Reasons
The disease occurs in familial hypertriglyceridemia, familial dysbetalipoproteinemia, decompensated diabetes mellitus, and rarely in familial lipoprotein lipase deficiency.
Symptoms
The disease is characterized by a sudden onset. Papules appear, first red and then yellow with a red rim, with clear boundaries, dome-shaped and hemispherical. The rash elements are often randomly located on the buttocks, back or elbows. When the papules merge, large plaques are formed.
Treatment
A low-fat diet is necessary.