- Main types of xanthoma
- What is xanthelasma?
- How to confirm the diagnosis
- How the treatment is done
- Treatment for gastric xanthoma
Xanthoma corresponds to the appearance of small lesions in high relief on the skin, formed by fats that can appear on any part of the body, but mainly on the tendons, skin, hands, feet, glutes and knees.
The appearance of xanthoma is more common in people who have very high cholesterol or triglycerides, although it can also occur in people who do not have cholesterol changes.
The presence of xanthoma is usually a sign that there is a greater amount of circulating cholesterol, which caused macrophages, which are cells of the immune system, to encompass fat cells, transforming into foamy macrophages and being deposited in the tissue. Thus, xanthoma is not a disease, but a symptom associated with a defect in the metabolism of fats and proteins that carry cholesterol in the body.
Main types of xanthoma
The formation of xanthoma is more common to occur in people who have unhealthy lifestyle habits, that is, who have a diet rich in fats and who are sedentary, which favors the accumulation of cholesterol and triglycerides. However, xanthoma can also occur as a result of other diseases, such as decompensated diabetes, biliary cirrhosis or liver failure.
According to their characteristics and location, xanthomas can be classified into:
- Xanthelasmas: are the type of xanthoma that is located on the eyelid, in the form of yellowish and softened plaques, usually in people with a history of high cholesterol; Eruptive xanthomas: they are the most common form of xanthoma and are associated with increased triglycerides, in which small yellow lumps appear, mainly in the thighs, legs, buttocks and arms. They usually improve when triglycerides are normalized; Tuberous xanthomas: yellowish nodules that are preferentially located on the elbows and heels of people with high cholesterol; Tendon xanthoma: it is the deposit that occurs in the tendons, mainly in the achilles tendon, in the heel, or in the toes, and also usually happens in people with high cholesterol; Flat xanthomas: they are flattened and appear more often in the palpate folds, face, trunk and scars.
There is also another form of xanthoma, which is gastric xanthoma, in which fatty lesions are formed in the stomach and which normally does not cause symptoms, being identified in endoscopies or gastric surgeries for other reasons. This type of xanthoma is rare, and its cause is not known exactly.
What is xanthelasma?
Xanthelasma is a type of xanthoma in which flat, yellowish plaques and lesions are found in the eyes, especially on the eyelids, usually symmetrically. The presence of xanthelasma is not contagious, since it is a response of the body to the greater amount of circulating cholesterol, and it is more frequent in adults who have disorders in the metabolism of fats.
Although not causing risk, xanthelasma can cause discomfort in the person due to the visibility of the lesions, so they request the removal of xanthelasma, which is done through surgery or through techniques that destroy xanthelasma, such as with acids, lasers or electrocoagulation, for example.
How to confirm the diagnosis
The diagnosis of xanthoma is clinical, that is, it is made by a dermatologist or general practitioner through the evaluation of the characteristics of xanthomas. In some cases, a blood test may also be indicated to check the amount of circulating cholesterol and triglycerides.
How the treatment is done
If the person with xanthomas has an excess of cholesterol or triglycerides detected in the blood test, the doctor will indicate the treatment to control these levels, with drugs called hypolipidemic drugs, such as Simvastatin, Atorvastatin, and fibrates, such as Fenofibrate or Bezafibrato, for example. In addition, procedures for removing fat deposits can be done, which must be done by the dermatologist, such as:
- Surgery for removal and closure with stitches: it is the safest, most effective option, can be done in the outpatient clinic, has low cost and produces excellent results; Chemical cauterization: more suitable for small and superficial lesions. It is done through the application of caustic substances such as trichloroacetic acid or combinations of acids; Laser treatment: through ultra pulsed carbon dioxide or pulsed laser; Cryosurgery: using liquid nitrogen or carbonic snow;
It is also very important that the treatment and control of other diseases associated with changes in metabolism and formation of xanthomas, such as diabetes, liver cancer, hypothyroidism or kidney diseases be carried out.
Treatment for gastric xanthoma
Gastric xanthoma or gastric xanthelasma are yellowish bags of cholesterol or lipids, with slightly irregular contours, which can measure 1 to 2 mm, located in the stomach. To treat this type of xanthoma it is necessary to have endoscopy and biopsy exams, and if signs of stomach cancer are ruled out, it is usually a benign situation, and the conduct should be observation, that is, it must be monitored frequently. to see the evolution of the problem.
However, if there is a risk of cancer formation or signs of worsening of the xanthoma, the doctor will be able to guide its removal, a procedure done through endoscopy.
