Xanthelasma
Xanthelasma (flat xanthoma of the eyelids) is a benign skin formation that manifests itself in the form of yellowish plaques slightly rising above the surface of the skin. Most often they are formed on the upper eyelid near the inner corner of the eye. There may also be similar formations (xanthemums) on other parts of the face and body. They indicate abnormal liver function, accompanied by lipid metabolism disorders, increased cholesterol levels in the blood. They look like blisters or fat cells. They do not bring discomfort, they grow slowly, and this process is not accompanied by pain, itching. Elderly women are most often at risk.
The content of the article:
Causes of xanthelasma
Symptoms of xanthelasma
Diagnosis of xanthelasma
Treatment of xanthelasma
Prevention of xanthelasma
Xanthelasma
Causes of xanthelasma
It is impossible to single out one specific reason why the disease occurs. Studies have shown that there is a link between this type of xanthemum and increased cholesterol in the blood. There are a number of diseases that increase the risk of xanthelasm of the eyelids: pancreatitis, diabetes mellitus, lipid metabolism disorders, liver diseases. There are studies confirming that the influence of heredity can be traced in the occurrence of neoplasms of this type. The manifestation of a violation of fat metabolism, which becomes noticeable during the first 12 months of life, is genetically determined.
Symptoms of xanthelasma
With xanthelasm of the eyelid, yellow plaques with a straw or orange tint are observed. They are soft to the touch. They come in the form of nodules protruding above the skin, or lines that differ from the skin only in color. They can be of various sizes (from 0.2 to 5 cm), grow slowly. Sometimes several small formations merge into one in the form of a bumpy elevation or a line with uneven edges. They are localized mainly in the area of the inner corner of the eye. At first, one plaque may suddenly appear, gradually new ones appear. They can be not only on the upper and lower eyelids, but also on the bridge of the nose. Xanthomas are similar to xanthelasma, in some cases they appear on the face, especially in the area of the lips, neck, elbow bends.
Xanthelasmas that have arisen once do not decrease in size and do not disappear. Their growth is not accompanied by any sensations. With a small size, they do not affect the activity of the visual organ and do not cause inconvenience. They are a pronounced cosmetic defect. Formations do not degenerate into malignant ones. Phospholipids and cholesterol are found inside the plaques.
They occur mainly in women, most often elderly, less often middle—aged. Sometimes they manifest in children, are a sign of hereditary xanthomatosis.
Diagnosis of xanthelasma
If symptoms of xanthelasma are detected, the patient should seek advice from a dermatologist and an endocrinologist. An examination is enough to make a diagnosis. At the same time, pressure is applied with a slide, this manipulation allows you to clearly determine the presence of yellowness. The process of pressing with xanthelasm does not cause pain.
When diagnosing, specialists find out what caused xanthelasma in each specific case, whether it is a pronounced manifestation of various diseases (if so, which ones). It is also important to determine whether the neoplasm is xanthelasma, and not dropsy, adipose or tumor.
The doctor also prescribes the following studies:
determination of the level of cholesterol in the blood serum. Normally, this indicator should not exceed 5.2 mmol/ l (venous blood is taken on an empty stomach);
examination of blood serum to determine the level of lipoproteins.
Treatment of xanthelasma
Since the nature of xanthelasma is not precisely defined, there is no specific treatment for this disease. First of all, the treatment of the disease is carried out, against which xanthelasma has developed, consisting in taking medications. Most often it is thyroidin and insulin.
With an increased content of lipids in the blood or a high level of cholesterol, appropriate medications are prescribed. In this case, in the treatment of xantheplasm of the eyelid, parmidine, cetamiphene, linetol, lipamide, diosponine, lipoic acid, clofibrate are used. Pyridoxine, nicotinic acid, ascorbic acid, choline chloride, calcium pangamate and other drugs are also used.
One of the ways to treat xantheplasma of the eyelid is to take herbal preparations. These are decoctions of immortelle flowers, birch buds, dandelion root, corn stigmas, plantain juice, rosehip fruits, etc. They have a choleretic effect, therefore, the obturation processes of the biliary tract are a contraindication to their reception.
Due to the peculiarities of xanthelasma, treatment by getting rid of the background disease does not lead to the disappearance or reduction of existing formations. But in this case, the plaques stop growing.
The only method of dealing with the patient’s existing formations is their removal. It is not mandatory from the point of view of medicine, since plaques do not pose a danger. Cases of their degeneration into malignant formations have not been described. But women often decide to remove plaques, as they are a cosmetic defect.
To remove xanthelasma , the following methods of exposure are used:
electric cauterization;
laser removal;
exposure to liquid nitrogen;
surgical intervention.
Electrocoagulation is the removal of plaques using an electric current. The formations are separated (local anesthesia is used), and their base is cauterized with an electrode. The wound quickly tightens, the crust departs after about a week, leaving a trace of pink color, which eventually fades.
One of the most effective is considered to be the method of destruction by laser exposure. Carbon dioxide laser is most often used. When using this bloodless method, a good cosmetic effect is achieved even in the presence of large xanthelasmas. Healthy skin is not affected. Local anesthesia is used.
Cryodestruction allows you to remove the formation using ultra-low temperatures without leaving scars. After exposure to liquid nitrogen, a dry scab is formed, leaving no later than 20 days later.
In some cases, a radio wave method is used to get rid of xanthelasm. It consists in the effect of radio frequency waves on the tissues of the formation.
When choosing a surgical method to solve the problem, the plaques are separated with tweezers and scissors. With tweezers, the edges of the wound are combined, iron and a half is applied locally, which allows to achieve a strong scab. If the formations are large, then after removing the xanthelasm, the edges of the wound are cauterized with electric current. To treat the wound surface after removal, solutions of brilliant green or potassium permanganate are used.
If large formations are accompanied by the problem of an overhanging eyelid, surgical excision is performed, as a result of which a suture is applied. After such an operation, a weakly pronounced scar remains.
Since patients with xanthelasma have a violation of lipid metabolism and an increase in cholesterol levels, one of the key aspects of treatment is the appointment and adherence to a diet. The recommended diet is almost similar to the diet for atherosclerosis.
Depending on the general state of health of the patient, it is necessary to completely abandon or minimize the consumption of fatty meats and offal. They also come with butter. Instead, it is necessary to use olive, corn or the usual sunflower oil.
It is necessary to fill your diet with fruits and vegetables. Due to their composition, they normalize lipid metabolism. 0.2 kg of fruits and 0.3 kg of vegetables make up the daily norm in this case. At least half of the norm of vegetables should be consumed without heat treatment (in the form of salad). This will provide the body with the necessary fiber.
White bread needs to be replaced with rye, gray, with bran. Instead of ground rice, you can use unpolished, brown rice. Switch to pasta made from durum wheat. Exclude semolina. Minimize the consumption of millet, corn, oats. They can be replaced with legumes. It is advisable to include at least one dish in the diet every day, which includes peas, lentils, chickpeas, beans.
It is necessary to avoid the consumption of trans fats. Omega-3 fatty acids in the diet are mandatory for this disease. They are found in fatty fish, pumpkin seeds, flax and nuts.
It is necessary to observe the drinking regime. Be sure to drink clean water during the day. The fluid norm is 1.5-2 liters per day.
For effective treatment, the patient needs to give up bad habits: exclude the use of alcoholic beverages, quit smoking. The use of narcotic or other toxic substances that create a load for the liver is unacceptable.
Normalization of motor activity is recommended.
Prevention of xanthelasma
Patients who are faced with this disease should know that the removal of formations is not a guarantee that new plaques will not arise over time. To prevent their appearance, it is necessary to eat a balanced diet. Eat as little fat as possible, especially of animal origin, adhere to a dairy-vegetable diet. It is necessary to take care of the skin of the eyelids, avoid injury.
Also, when this disease occurs, specialists need to monitor the cardiovascular system. Regular visits to the therapist are especially relevant for those patients whose disease is not accompanied by an increase in the level of lipids and cholesterol in the blood, since there is a risk of early development of coronary heart disease, atherosclerosis. There are studies proving the relationship of the appearance of xanthelasma with the risk of myocardial infarction and death due to heart disease.
Also, patients need to visit an ophthalmologist regularly (twice a year). Abstinence from excessive physical exertion is important in the prevention of the disease.
