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Skin xanthomas: causes, symptoms, diagnosis, treatment
Last reviewed: 28.10.2023
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Xanthoma tuberous (synonyms: multiple xanthoma, primary hypercholesterolemic xanthomatosis).
Xanthoma of the skin, in particular multiple tuberous xanthomas, is one of the manifestations of impaired lipid metabolism.
Causes and pathogenesis. An increase in the level of triglycerides and cholesterol in the blood plasma was found because of a disruption in the formation, transport and splitting of lipoproteins. Clinically distinguish eruptive, tuberous, tendon and flat xanthomas.
Symptoms. For the multiple tuberose xanthoma, the presence of symmetrically located knotty tumor-like formations is yellowish or brown in color, a dense consistency, ranging from a large pea to a walnut, welded into a conglomerate. A reddish-cyanotic fringe can be observed around the elements. Subjective sensations are not noted. Elements are localized mainly in the area of large joints - knee and elbow, as well as on the buttocks, shoulders, the back surface of the fingers, the face skin, the scalp. With a diascopy, a characteristic yellowish background of the foci is noted. Tuberous xanthoma is combined with other varieties of xanthom and can be combined with the pathology of internal organs (atherosclerosis of the heart vessels, nephrosclerosis).
Histopathology. In the epidermis there is hyperkeratosis, it has a normal thickness. In the reticular layer of the dermis, infiltrates are observed, consisting of lymphocytes, foamy mono- or multinucleate giant cells.
Differential diagnosis. The disease should be distinguished from lipoma, eruptive xanthoma, rheumatoid nodules.
Treatment. First, they recommend dairy-vegetable food, limiting the intake of fats. At the same time, normalization of disturbed lipid metabolism and visceral disorders is necessary. Apply surgical removal of large nodes and tumors, diathermocoagulation of small formations.
Eruptive xanthomas
Synonyms: papular xanthoma, multiple nodal xanthomas
Causes. The disease occurs with familial hypertriglyceridemia, familial disbetalipoproteinemia, decompensated diabetes mellitus, and rarely - with familial deficiency of lipoprotein lipase.
Symptoms. Characterized by a sudden onset of the disease. Appear papules first red, and then yellow with a red rim, with clear boundaries, domed and hemispherical shape. Elements of the rash are often located randomly on the buttocks, back or elbows. When the papules merge, large plaques form.
Treatment. It is necessary to comply with a diet low in fat.