Xanthelasma 

• Most common of all xanthomas. In most cases, an isolated finding unrelated to hyperlipidemia.

• Occurs in individuals >50 years; however, when in children or young adults, it is associated with familial hypercholesterolemia (FH) or familial dysbetalipoproteinemia (FD).

• Skin lesions are asymptomatic. Soft, polygonal yellow-orange papules and plaques localized to upper and lower eyelids and around inner canthus. Slow enlargement from tiny spots over months to years.

• Cholesterol should be estimated in plasma; if enhanced, screening for type of hyperlipidemia (FH or FD). If resulting from hyperlipidemia, complication with atherosclerotic cardiovascular disease may be expected.

• Laser, excision, electrodesiccation, or topical application of trichloroacetic acid. Recurrences are not uncommon.