The pathogenesis and clinical significance of xanthelasma palpebrarum

Xanthelasma palpebrarum is the most common type of xanthoma. On average, only half the patients with xanthelasma palpebrarum are hyperlipidemic. This review is an attempt to elucidate the pathogenesis and clinical significance of xanthelasma palpebrarum, especially its suggested role as a marker for increased risk for atherosclerosis. In hyperlipidemic patients with xanthelasma, the risk for atherosclerosis may be inferred from the associated lipoprotein and apolipoprotein abnormalities. The possible risk for atherosclerosis in normolipidemic patients with xanthelasma is more obscure because of the relative paucity of epidemiologic data and the conflicting results in some of the lipid studies. Several studies, however, showed decreased high-density lipoprotein cholesterol levels and other lipoprotein and apolipoprotein abnormalities that are associated with atherosclerosis. Therefore, on the basis of the present data, determining the plasma lipoprotein and apolipoprotein levels (especially those associated with increased risk for atherosclerosis) in each normolipidemic patient with xanthelasma appears to be justified.