Dermatopathology

Xanthelasma

A subtype of xanthomas, xanthelasmas are clinically soft, yellow plaques that have a predilection for the eyelids and the periorbital skin, often bilaterally. Xanthomas are associated with hereditary lipoproteinemias.

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Slide 1: The patient is a 66 year old female with a right upper eyelid lesion. The shave excision specimen is bisected.

Slide 2: Collections of lipid laden macrophages are seen within the corium.

Slide 3: These sheets of foamy macrophages involve the dermis and the surrounding adnexal structures.

Slide 4: Areas of chronic inflammation characterized by lymphocytes are also observed amidst the lipid laden macrophages, which comprises the majority of the specimen.