Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Outcomes of Surgical Management of Xanthelasma Palpebrarum

  • Lee, Hoon Young (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine) ;
  • Jin, Ung Sik (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine) ;
  • Minn, Kyung Won (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine) ;
  • Park, Young-Oh (Ever Plastic Surgery Clinic)
  • Received : 2013.02.07
  • Accepted : 2013.05.27
  • Published : 2013.07.15
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Abstract

Background Xanthelasma palpebrarum (XP) is a benign disorder manifesting as yellowish cholesterol-laden plaques on the eyelids. This paper presents the outcomes in patients with XP who have undergone surgical excision as the main modality of treatment. Methods A retrospective review of patients who received surgery for xanthelasma palpebrarum from March 2007 to March 2011 was conducted. Patients were classified into four grades according to the location and extent of the lesion, with grade I being the mildest and grade IV being the most diffuse. Simple excision was performed in grade I and II lesions, while local flaps and skin grafts were performed in the more advanced grades. Results Ninety-five cases from March 2007 to March 2011 were included in this study. 66 cases (70%), were treated by simple excision. Twenty-four cases (25%) and 5 cases (5%) were treated by simple excision in combination with or without local flaps and skin grafts. In approximately 1/4 of the patients, orbicularis oris muscle involvement was observed. 4 patients (4.2%) developed scar contracture postoperatively, which required a secondary procedure. Recurrence was reported in 3 patients (3.1%). Otherwise. There were no other reports of major complications or disfigurement. Conclusions We found that for lesions involving the deep dermis and/or muscle, surgical excision was the most appropriate therapeutic option.

Keywords

References

  1. Rohrich RJ, Janis JE, Pownell PH. Xanthelasma palpebrarum: a review and current management principles. Plast Reconstr Surg 2002;110:1310-4. https://doi.org/10.1097/00006534-200210000-00016
  2. Bergman R. The pathogenesis and clinical significance of xanthelasma palpebrarum. J Am Acad Dermatol 1994;30:236-42. https://doi.org/10.1016/S0190-9622(94)70023-0
  3. Mendelson BC, Masson JK. Xanthelasma: follow-up on results after surgical excision. Plast Reconstr Surg 1976;58:535-8. https://doi.org/10.1097/00006534-197611000-00001
  4. Raulin C, Schoenermark MP, Werner S, et al. Xanthelasma palpebrarum: treatment with the ultrapulsed CO2 laser. Lasers Surg Med 1999;24:122-7. https://doi.org/10.1002/(SICI)1096-9101(1999)24:2<122::AID-LSM7>3.0.CO;2-6
  5. Borelli C, Kaudewitz P. Xanthelasma palpebrarum: treatment with the erbium:YAG laser. Lasers Surg Med 2001;29:260-4. https://doi.org/10.1002/lsm.1117
  6. Cannon PS, Ajit R, Leatherbarrow B. Efficacy of trichloroacetic acid (95%) in the management of xanthelasma palpebrarum. Clin Exp Dermatol 2010;35:845-8. https://doi.org/10.1111/j.1365-2230.2010.03818.x
  7. Fusade T. Treatment of xanthelasma palpebrarum by 1064-nm Q-switched Nd:YAG laser: a study of 11 cases. Br J Dermatol 2008;158:84-7.
  8. Ozdol S, Sahin S, Tokgozoglu L. Xanthelasma palpebrarum and its relation to atherosclerotic risk factors and lipoprotein (a). Int J Dermatol 2008;47:785-9. https://doi.org/10.1111/j.1365-4632.2008.03690.x
  9. Mittelviefhaus H, Kreusser C, Bohringer D, et al. The underestimated depth of tissue invasion of xanthelasma: a histological study. Klin Monbl Augenheilkd 2011;228:14-8. https://doi.org/10.1055/s-0029-1245829
  10. Park EJ, Youn SH, Cho EB, et al. Xanthelasma palpebrarum treatment with a 1,450-nm-diode laser. Dermatol Surg 2011;37:791-6. https://doi.org/10.1111/j.1524-4725.2011.01945..x
  11. Hintschich C. Argon laser coagulation of xanthelasmas. Ophthalmologe 1995;92:858-61.
  12. Katz TM, Goldberg LH, Friedman PM. Fractional photothermolysis: a new therapeutic modality for xanthelasma. Arch Dermatol 2009;145:1091-4. https://doi.org/10.1001/archdermatol.2009.234
  13. Karsai S, Schmitt L, Raulin C. Is Q-switched neodymiumdoped yttrium aluminium garnet laser an effective approach to treat xanthelasma palpebrarum? Results from a clinical study of 76 cases. Dermatol Surg 2009;35:1962-9. https://doi.org/10.1111/j.1524-4725.2009.01314.x
  14. Lieb WE, Klink T, Munnich S. CO2 and erbium YAG laser in eyelid surgery. A comparison. Ophthalmologe 2000;97:835-41. https://doi.org/10.1007/s003470070004
  15. Lowry JC, Bartley GB, Garrity JA. The role of second-intention healing in periocular reconstruction. Ophthal Plast Reconstr Surg 1997;13:174-88. https://doi.org/10.1097/00002341-199709000-00004

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