Xanthoma

Xanthomas are mostly yellowish, cholesterol-rich deposits in tendons or other parts of the body. These fatty tissue can form and settle under the surface of the skin in various forms. Xanthomas are usually associated with hyperlipoproteinemia (high blood cholesterol).

What is a xanthoma?

The term Xanthoma is subordinate to the term Xanthelasma and describes fatty deposits under the skin that have developed a distinctive size.

Even if they are mostly yellow in color, the deposits can also be brownish, reddish, beige or cream in color. Xanthomas vary widely in size and shape. Points the size of a pinhead, which often occur in clusters, strongly protruding knots, round, even surfaces, or uneven sponges are possible. Although the deposits are most prominent on the skin, they can also appear on bones, blood vessels and organs.

Xanthomas themselves are not dangerous, but they usually occur in connection with lipid metabolic diseases. If triggered by high cholesterol levels in the blood, they can dissolve again even if they are brought under control.

causes

There are a variety of causes that are related to the lipid metabolism disorder which the Xanthomas trigger. Lipids combine with proteins in the blood. These lipoproteins carry cholesterol and other fats to various places in the body.

If this process is subject to fluctuations and irregularities, xanthomas are deposited. The reason for this can be genetic predispositions, but also other diseases that are not infrequently associated with a healthy lifestyle. The first include diabetes mellitus, but drugs can also cause these disorders. As a result, if xanthomas occur as part of secondary hyperlipoproteinemia, there can be many causes.

These include alcoholism, overeating, malnutrition, panctreatitis (inflammation of the pancreas), liver disease, cholestasis (biliary stasis), hyperuricemia (increased uric acid level in the blood), hypothyroidism (underactive thyroid), acromegaly (enlarged limbs), glycogenosis (disturbed extremities) , Hypercalcaemia (high levels of calcium in the blood).

Typical symptoms & signs

• High cholesterol level (hypercholesterolaemia)
• plaque-like lumps with fatty deposits in the skin

Diagnosis & course

Xanthomas can appear on many parts of the body: on ankles and joints (Xanthoma tuberosum); on hands, feet or the Achilles tendon in the form of knots (Xanthoma tendinosum), yellowish-orange knots all over the body (eruptive xanthoma); Scattered points over large areas of the skin (Xanthoma planum); on the fingers (palmar xanthoma); red lumps that look inflamed (tuberoeruptive xanthoma).

Depending on the location and type of occurrence, they can be indicators of various diseases, but do not necessarily have to be, so the diagnosis of the underlying disorder is not always easy. Xanthomas can remain permanent or appear sporadically in certain regions and then disappear again. They usually resolve when the underlying disease has been cured or the causes of the disease have been brought under control.

Complications

When people have xanthoma, the main problem is that they have very high levels of cholesterol in the blood. This high content generally has a very negative effect on the patient's health and can also significantly reduce life expectancy. Furthermore, the xanthoma causes deposits under the skin and also in the skin.

Fat is deposited in the form of small knots. Many sufferers feel uncomfortable with these complaints and suffer from inferiority complexes or from a significantly reduced self-esteem. Especially in children, these aesthetic complaints can lead to bullying or teasing and thus also cause depression and other psychological upsets.

Due to the high level of cholesterol, the risk of a heart attack also increases. This can also lead to inflammation of the pancreas. Usually the disease can be treated with medication. However, those affected must also change their lifestyle and pursue a healthy diet. There are no particular complications. A xanthoma can also be removed with the help of surgery.

When should you go to the doctor?

Changes in the complexion that persist over a long period of time or that have an unusual appearance should always be examined by a doctor. Clarification of the cause is necessary if there are sudden abnormalities or an increase in symptoms over a longer period of time. Often times, skin changes are symptoms of an existing disorder that requires medical attention. Lump formation in the upper layers of the skin is considered unusual.

Unusual fat deposits are equally worrying. A visit to a doctor is advisable so that a diagnosis can be made. If there is discoloration of the skin, this indicates a health impairment for which a treatment plan is required. In particular, yellowish and white discolorations should be presented to a doctor. Poplars, skin subunits, decreased well-being and impairments in coping with everyday tasks are indications of a disease.

Medical care is required to alleviate the symptoms. If the patient's hands and Achilles tendon can no longer be moved without symptoms, a doctor is required. If there are impairments in the performance of usual sporting activities, the cause should be clarified. If the person concerned notices changes in the trunk area, this must also be interpreted as a warning signal from the organism and must be examined by a doctor.

Treatment & Therapy

The basic treatment of Xanthomas is directly related to the underlying disease. Once identified, it should be targeted. In many cases, this treatment will also reduce the xanthomas.

In addition, treatment for high blood cholesterol will reduce the risk of heart attack and the risk of inflammation of the pancreas. A targeted diet and a change in lifestyle will lead to an improvement in the lipid metabolism disorder, with or without medication. When it comes to nutrition, it is important to ensure that most dishes are prepared from fresh vegetables, lettuce, cereals and fish.

It should reduce saturated fats, which are mainly found in meat, butter and other dairy products. Food and drinks that contain a lot of refined sugar should be reduced significantly. These include lemonades, sweets, cakes, etc. If you are overweight, the calorie intake should be slowly reduced in order to achieve a healthy body weight. Xanthomas that do not resolve after treatment can also be surgically removed.

prevention

Around Xanthomas and to prevent the associated diseases, blood cholesterol and blood pressure should be checked regularly, especially after reaching a certain age. Essential prophylaxis is of course a healthy lifestyle with plenty of exercise, a balanced diet and moderate consumption of alcoholic beverages.

Aftercare

There are two approaches to follow-up treatment, depending on how and what type of xanthoma was treated. On the one hand after a surgical removal and on the other hand after the treatment of the basic disease. The follow-up measures differ depending on the treatment that took place.

If the xanthoma is surgically removed, it is strongly advised to keep the necessary follow-up appointments. The attending physician decides in advance whether one appointment is sufficient or whether several are necessary. In all types of skin operations and their follow-up treatments, patients should make sure that UV light can promote the regeneration of certain pigmentations and disorders on the injured skin.

If the xanthoma was surgically removed, the skin should be treated with sunscreen for up to eight weeks. This should have a high UVA and UVB sun protection factor. In addition, the treated skin area should not come into contact with water in the first few days after treatment. In addition, those affected should avoid sport and other physically demanding activities for at least two weeks.

In general, the treated part of the body should be moved less than usual for the first few days, as this allows healing to progress better. If the possible underlying disease has been treated, it is essential to follow a special low-fat diet. The regular intake of lipid-lowering drugs is also part of regular follow-up and preventive care.

The goal is a sustainable lifestyle modification. Blood tests at regular intervals and check-ups with the dermatologist are necessary here. This ensures that there is no new xanthoma formation.

You can do that yourself

To alleviate the existing symptoms, an optimization of the lifestyle is necessary. It is imperative to refrain from consuming alcohol. There is a particular need for action in the case of addictive behavior. In most cases, however, medical support is required because the person concerned often does not have the necessary discipline to change the situation in the long term.

Food intake should also be checked and optimized. Many people affected have fat deposits in their bodies because they eat unhealthily. At the same time, there is usually a lack of exercise that needs to be remedied. Meal intake should be controlled and reduced. A long-term, balanced diet rich in vitamins is necessary to improve the general state of health. Adequate exercise, sporting activities and a regular supply of oxygen are also important to increase well-being and reduce discomfort.

The weight should be in the normal range of the BMI. Otherwise, countermeasures must be initiated. A reduction in fat when eating helps to gradually lose excess weight. Diet programs offered can also be used to achieve improvements. It is advisable to take part in a nutritional consultation in order to record and optimize the effects of food intake.