XANTHOMA

Synonyms: Xanthelasma; Vitiligoidea; Fibroma lipomatodes.

Xanthomata are unique, butter colored, benign new
growths. Two types are recognized, xanthoma
planum and xanthoma tuberosum. The flat xan-
thomata are seen by far most frequently upon
the eyelids (Xanthoma palpebrarum). They ap-
pear as round, oval or elongated, circumscribed,
slightly raised, flat, yellow patches that increase
in size very gradually and may in time form
a ribbon like band upon the palpebral margin. The
original lesions rarely coalesce, however, but on
close inspection are found to be merely very closely
contiguous. The tumors are about the consistency
of the normal skin, there is no palpable infiltration.
Their surface may be smooth or finely wrinkled.
When the growth is put upon the stretch its color
becomes more pronounced, and with a lens, or
sometimes with the naked eye, it can be seen to be
composed of an aggregation of miliary yellow specks
each with a minute reddish central point. While
these tumors are located most frequently upon the
eyelids they occur also at times widely distributed
over the skin, and have been found upon the mucous
and serous surfaces inside the body. The tuber-
cular form is less common and differs from the one

just described only in that the tumors are more
elevated, rounded, firmer and often larger. They
are located more often upon the hands, elbows,
knees, buttocks and other points of pressure. When
the two types are associated the disease is usually
described as xanthoma multiplex. Xanthomata de-
velop slowly. After a time the lesions become sta-
tionary; very rarely do they show any tendency to
undergo involution. They occur more frequently
in women than in men and are observed usually
in patients of middle or advanced age. They rarely
cause any subjective symptoms, at most only slight
itching or tingling. DIAGNOSIS; The only other
tumor that even remotely resembles xanthoma is
milium, the little sebaceous cysts that form some-
times about the eyelids. They are much paler and
firmer than xanthomata and after puncture of the
epidermis their contents can be expressed. TREAT-
MENT: The best results are obtained by congelation. The growths should be frozen for from one-half to one minute with molded carbon dioxid snow dipped in ether. A second and third application may be necessary after the crust of the first freez-ing has fallen off. When the growth is entirely
destroyed it does not tend to recur.

HST. 000001. 060