Xanthoma 

Xanthoma is a type of skin condition characterized by the development of yellowish-brown fat deposits beneath the skin. These fatty deposits are typically seen in the superficial layer of the skin or the layers of connective tissue beneath the skin. Xanthomas are often associated with an underlying health condition such as high cholesterol levels, diabetes, or certain types of inherited lipid disorders. The fatty deposits may appear as flat or raised bumps of varying size. Xanthomas can occur anywhere in your body but are commonly found on the hands, elbows, buttocks, knees, or feet. Treatment of xanthomas usually involves addressing the underlying medical condition. It may also include lifestyle changes, medications to manage cholesterol levels, or surgical intervention to remove the fatty deposits in severe cases.  

Read on to learn about Xanthomas, from their types, causes, symptoms, diagnosis, and treatment modalities, to help you identify the condition and seek medical help!  

What is Xanthoma?

Xanthomas are tiny skin bumps or blemishes that develop due to an abnormal buildup of fats under the surface of your skin. They can even develop on the surface of your internal organs. Though they are not contagious and dangerous, the fatty bumps indicate the presence of an underlying health condition like high cholesterol or diabetes.  

Though they can occur anywhere in your body, they are common in areas such as hands, feet, buttocks, and joints (knees and elbows). The bumps may vary in size, ranging from as small as a pinhead to as large as a grape. They often appear brown, yellow, or orange and do not cause pain or discomfort. However, they may be tender, itchy, and aesthetically unappealing.

What Are the Types Of Xanthomas?

Depending on the location, xanthomas are of several types:

• Xanthelasma: Fatty deposits underneath the skin, usually on or around the eyelids. 
• Xanthoma tuberosum: Xanthomas are located over the tuberosity of the joints.
• Xanthoma tendinosis: This type is clinically characterized by papules and nodules found in the tendons of the hands, feet, and heel. 
• Eruptive xanthoma: Xanthomas appear as small yellowish papules surrounded by an erythematous halo all over the body, especially the bands and buttocks. 
• Xanthoma planum: It is characterized by bands or macules and plaques in the dermis (middle layer of the skin) spread diffusely over large body areas.
• Palmar xanthoma: This type is characterized by yellowish plaques that involve the palms and fingers.

What Causes Xanthoma?

Xanthomas usually occur as a result of another type of health problem. They are caused by an excess of blood lipids (a type of fatty tissue) in your body. You may develop xanthomas due to any one of the following underlying conditions:

• Hyperlipidemia (high blood cholesterol levels)
• Diabetes (high blood sugar levels)
• Hypothyroidism (a condition where your thyroid does not produce enough hormones)
• Primary biliary cirrhosis (a disease characterized by the slow destruction of the bile ducts in the liver)
• Cholestasis (slow flow of the bile from your liver)
• Nephrotic syndrome (a disorder that damages the blood vessels in the kidneys)
• Hematologic disease (genetic disorders that affect your body's ability to break down substances and to maintain bodily functions)
• Cancer (abnormal and uncontrolled multiplication of cells in your body causing a tumor)
• Side effects of certain medications such as prednisone and cyclosporine.

What Are the Symptoms of Xanthomas?

Xanthomas appear as tiny, soft bumps of fatty tissues that can grow as large as 3 inches across. They may appear as a single bump or in clusters. They differ in shape, size, and color, appearing reddish, brownish, or yellowish. The bumps can be itchy or tender to the touch. 

How is Xanthoma Diagnosed?

If you have any soft, flat, small bumps underneath your skin surface, you should see a dermatologist to determine what is causing it. Apart from the clinical signs, your doctor may physically examine the bumps and recommend further testing to confirm the diagnosis. These include:

Biopsy

• Your doctor may take a sample of the fatty bumps and send it to the lab for analysis. This test helps rule out malignancy (being cancerous).  

Cholesterol Tests

• Your doctor will probably order a blood test to check the blood lipid levels, including cholesterol and triglyceride levels.  

Additional Blood Tests

• Check irregularities that may indicate diabetes, liver disease, or thyroid problems. 

How is Xanthoma Treated? 

The main aim of treating xanthomas is to address the underlying health condition that is causing the abnormal accumulation of fatty deposits underneath the skin.  

Here are some common approaches to managing xanthomas:

Lifestyle Modification

• Adopt a healthy diet low in saturated fats and cholesterol
• Enhance in regular physical activity
• Maintain a healthy weight through a well-balanced diet and regular exercise
• Avoid smoking and excessive alcohol consumption
• Manage stress through relaxation techniques like Yoga and meditation.

Medications 

• Your doctor may prescribe medicines to lower cholesterol levels and reduce the risk of other fatal medical conditions.
• These include fibrates, statins, or cholesterol absorption inhibitors.  

Surgical Intervention 

• Large, unsightly xanthomas causing discomfort may be removed surgically. 
• Your doctor will numb the affected area using local anesthesia and remove the fatty deposits with appropriate surgical instruments. 

Laser Therapy

• Small, superficial xanthomas can be treated using laser light of different wavelengths.
• The light converts into heat energy to shrink the fatty deposits. 

Cryotherapy 

• This method involves freezing the xanthomas with liquid nitrogen to destroy the fatty deposits.  

Conclusion

Xanthomas are yellowish-brown, small, flat, or raised fat deposits found beneath the skin in areas like eyelids, elbows, hands, feet, knees, and buttocks. Though they are not dangerous or contagious, it is essential to seek medical help since the underlying medical condition causing them can be life-threatening.  

By adopting a healthy lifestyle, managing the underlying health conditions, and seeking regular medical care, you can reduce the risk of developing xanthomas or manage the fatty deposits and other complications associated with them. However, if lifestyle changes cannot manage the fatty deposits, dermatologists may recommend advanced procedures like surgery, laser therapy, or cryotherapy.