Yellow plaques that occur most commonly near the inner canthus of the eyelid.

Occur more often on the upper lid than the lower lid.

Xanthelasma palpebrarum is the most common cutaneous xanthoma.

Can be soft, semisolid, or calcified..

Frequently symmetrical, and may involve all 4 eyelids.

Usually are located on the medial side of the upper eyelids.

Tendency to progress and become permanent.

Half of these lesions are associated with elevated plasma lipid levels.

Frequently occur in patients with type II hyperlipidemia and in the type IV phenotype.

Some occur with lowered high-density lipoprotein levels.

Rare in the general population.

Predominance of xanthelasma in women.

Age of onset peaks in the fourth and fifth decades.

Most common type of xanthoma.

Once established, they remain stable or increase in size.

Generally, do not affect the function of the eyelids.

Can be seen in primary and secondary causes of hyperlipidemia, and in poorly controlled diabetes.

Most cases occur in normolipemic persons who may have low HDL cholesterol levels or other lipoprotein abnormalities.

Composed of xanthoma cells which are foamy histiocytes laden with intracellular fat deposits primarily within the upper reticular dermis.

Main lipid that is stored is cholesterol, which is esterified.

Dietary and drug treatment to reduce serum lipids, show only limited response.

Surgical options include: excision, laser ablation, chemical cauterization, electrodesiccation, and cryotherapy.

Surgical excision recommended for small lesions.

Chemical cauterization with chlorinated acetic acids has been found to be effective in the removal of xanthelasma.

Recurrence is common after treatment.

Recurrence rate up to 40% of patients with surgical excision.

Failure rate higher with second excisions, in patients with hyperlipidemia syndromes, and when all eyelids are involved.

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