Xanthelasma are the most common type of xanthoma. They often present in the absence of xanthomas elsewhere on the body, although histologically they are the same. Once plaques are established, they will remain static or increase in size. Patients generally complain about aesthetic concerns. Xanthelasma or xanthoma palpebrarum usually are located on the medial side of the upper eyelids.
Lesions are yellowish, soft, and form plaques.
Generally, these lesions do not affect the function of the eyelids, but ptosis has been known to occur. Eruptive xanthomas can be seen in primary and secondary causes of hyperlipidemia. Examples of primary genetic causes include familial dyslipoproteinemia, familial hypertriglyceridemia, and familial lipoprotein lipase deficiency. Diabetes that is out of control is a common cause of secondary hyperlipidemia. However, most xanthelasma occur in normolipemic persons who may have low HDL cholesterol levels or other lipoprotein abnormalities.