Xanthelasma in heart disease: signs, symptoms, and causes

2021-08-28 09:05 PM

In hyperlipidemic patients with xanthelasma, elevated cholesterol, mostly LDL, crosses the vessel wall forming subcutaneous plaques.

Description

Yellow, well-defined patches of cholesterol are commonly seen around the eyes.

Xanhelasma: Yellow tumor eyelids

Image. Yellow tumor eyelids

Cause

Hypercholesterolemia (although only 50% of people with xanthelasma have high blood lipids).

Diabetes.

Fredrickson hyperlipidemia.

Primary biliary fibrosis.

Mechanism

Patients with blepharospasm usually have abnormal lipid profiles with high LDL and low HDL. However, the mechanisms involved are varied, depending on whether the patient has normal or higher than normal blood lipids.

Hyperlipidemia

In hyperlipidemic patients with xanthelasma, elevated cholesterol, mostly LDL, crosses the vessel wall forming subcutaneous plaques.

Normal blood lipids

The mechanism is unclear, but the possibilities are as follows:

Local injury and inflammation are thought to alter vascular permeability, allowing lipoproteins to enter the dermis and be absorbed by skin cells.

Skin macrophages, cells that are not regulated by the body's normal mechanisms (which limit the cells' absorption of LDL cholesterol), feed on cholesterol and become foam cells, firmly attached to the dermis.

HDL, which normally helps remove excess cholesterol from tissues, is low in patients with xanthelasma; so very little cholesterol is moved out of the tissue and accumulation occurs.

Significance 

The value of blepharospasm as a symptom and predictor of the disease remains to be determined. However, there are a few that are known including:

The incidence of arteriosclerosis in patients with xanthelasma varied between 15% and 69% in different studies.

Recent studies have shown an increased risk of ischemic heart disease for men over the age of 50. There was no increased risk of heart disease for women, and no association with peripheral vascular disease was found in the studies.

Patients with hyperlipidemia and xanthelasma are at increased risk of cardiovascular disease, and monitoring should be based on cholesterol and lipoprotein abnormalities.

In patients with normal blood lipids, the specificity of xanthelasmas is less clear, due to the lack of well-researched studies and some conflicting data.

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