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Xanthelasma (Xanthoma)


Xanthomas are yellow dermal deposits in the eyelid skin and generally around the eyes. They normally occur in cllusters and come in different sizes ranging from a millimeter to several inches. 


Xanthomas are cholesterol deposits and are associated with hyperlipidemia, which can be caused by a number of conditions: genetic disorders, diabetes mellitus, hypothyroidism, Cushing syndrome, pancreatitis and renal disease. The nodules in the eyelid skin are believed to be caused by high triglycerides or fatty acids in the blood. 


Xanthomas are usually painless but sufferers are advised to check their cholesterol and lipids levels.  These dermal nodules may look unsightly but they do not interfere with vision and they can easily be removed by electrolysis.

Syringoma presents with multiple small, firm, flesh or yellow coloured papules, 1 to 3mm in diameter, that form on the upper cheeks and upper and lower eyelids.  Syringomas can also be found in the armpits, abdomen, chest, neck, scalp and groin areas. The papules are benign adenomas of the eccrine (sweat) ducts which lie around the skin hair follicles deep in the dermis and, in some cases, multiply prolifically.

​​The ducts become enlarged when they get clogged with extra cells, forming hard, round, raised bumps about one to three millimetres in diameter that can be white, yellowish or skin coloured. They are benign and painless.


They are more common in women and most frequently appear during or after adolescence. Genetic link and hormonal influece has been suggested, explaining the female predominance. Several systemic syndromes have been associated with syringoma. For example, syringoma consisting of nests of clear cells, containing glycogen, is associated with the elevated glucose levels seen in diabetes mellitus. Gluten-free diet may be advised.   


Usually, syringomas develop over time, but some people may experience sudden, or eruptive syringomas, which is often accompanied with itchiness, redness and pain. Any case of erruptive syringoma should be medically evaluated.

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In the majority of cases syringomas do not require treatment.  However, if they are seen cosmetically unappealing or prone to itching, syringoma papules can be treated by electrocautery for cosmetic reasons. A thin probe delivers electrical current to syringoma which destroys abnormal tissue.  This, however, does not eliminate the underlying causes and the condition can recur.

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