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Therapeutic Approach

Xanthomas are yellow-orange hued plaques or nodules of accumulated excess lipid deposited in the skin or tendons. The main clinical subtypes of xanthomas include eruptive, tuber-eruptive or tuberous, tendinous, or planar forms. Other less common subtypes include verruciform and disseminated xanthomas, which are often noncutaneous. Xanthomas are not distinct disease entities, but rather often signs of underlying primary lipid disorders (eg, Fredrickson-Levy-Lees phenotypes I, IIa, IIb, III, IV, and V), or secondary causes of lipid dysfunction (eg, due to hematologic, hepatic, nephrotic, genetic, or metabolic abnormalities, or drugs). Sometimes there may not be any associated lipid abnormalities, as with some palpebral xanthelasmas and verruciform xanthomas. Although cutaneous xanthomas themselves generally have a relatively benign course, treatment mainly aims to address any underlying hyperlipidemia and prevent morbidity and mortality from untreated atherosclerotic disease through lifestyle modification and medications. In addition, removal or destruction of xanthomas for functional and/or aesthetic reasons may be offered, especially in cases of normolipidemic xanthomas. See Table 126-1.

Table 126-1Xanthomas Treatment Table

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