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Yellow deposits below eyelids
Question :
Mehmet Davutoglu, Sezai Sasmaz
Department of Pediatrics and Dermatology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, 46050, Turkey.

Address for Correspondence: Dr. Mehmet Davutoglu, Assistant Professor, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey.
E-mail: drmdavutoglu@hotmail.com

An 8-year-old girl presented with small yellow deposits on both eyelids and periorbital area lasted for one year {Figure 1}. These lesions were first seen on the lower lids and then progressively enlarged and spread to the upper lids and periorbital area. She had no similar lesions elsewhere on her skin. Routine laboratory investigations` complete blood cell count, urinalysis, serum chemistry, including blood glucose, liver function tests, and lipid profile were all normal. What is the diagnosis___?
 
Answer :
She was diagnosed as xanthelasma. Xanthelasma is the most common cutaneus xanthoma and presents as asymptomatic, generally bilaterally symmetrical yellow plaques, most commonly near the inner canthus of the eyelid {1}. One half of these lesions are associated with elevated plasma lipid levels. They frequently occur in patients with type II hyperlipidemia. These asymptomatic minor growths have a tendency to progress, coalesce, and become permanent and may be disfiguring. Therapy is usually undertaken only for cosmetic reasons {2}. It can be removed with trichloroacetic acid peel, surgery, lasers or cryotherapy {3, 4}.

References
1. Bergman R. The pathogenesis and clinical significance of xanthelasma palpebrarum. J Am Acad Dermatol 1994` 30: 236.
2. Xanthelasma. Available at website: ww.uptodate.com, contents, eyelid-lesions#H3. Accessed on 31st Jan 2012
3. Haygood LJ, Bennett JD, Brodell RT. Treatment of xanthelasma palpebrarum with bichloracetic acid. Dermatol Surg 1998` 24: 1027.
4. Raulin C, Schoenermark MP, Werner S, Greve B. Xanthelasma palpebrarum: treatment with the ultrapulsed CO2 laser. Lasers Surg Med 1999` 24: 122.

E-published: February 2012 Vol 9 Issue 2 Art # 12

DOI No. : 10.7199/ped.oncall.2012.12