What are the other Names for this Condition? (Also known as/Synonyms)

• Xanthoma Planum

What is Plane Xanthoma? (Definition/Background Information)

• Plane Xanthoma is the formation of flat lesions on skin due to metabolic disorders, such as hypertriglyceridemia or hyperlipidemia, in some cases; or, from unknown causes (idiopathic)
• Triglycerides and lipids are certain types of fatty substances that are important for providing energy to the body, and the term “hyper” denotes an excess of the same in the body
• Plane Xanthoma is associated with xanthelasma palpebrarum, which causes small yellow lesions on the eyelids. It is generally observed in young, middle-aged, and older adults
• The abnormal cutaneous lesions are known as xanthomas. The lesions are usually painless and numerous, appearing in patches. They can be present anywhere in the body; commonly, near the joints, on the back, shoulders, and face
• In a majority of cases, treatment of the underlying lipid condition through diet control, exercises, and prescription medications, is undertaken. The xanthomas may be treated through laser therapy or surgery, if required
• The prognosis for Plane Xanthoma is good with suitable treatment of the underlying condition causing the skin lesions. However, there is a chance of recurrence following treatment, if lipid levels increase abnormally

Who gets Plane Xanthoma? (Age and Sex Distribution)

• Plane Xanthoma is an uncommon condition that is usually observed in adults. When associated with inherited genetic disorders, it may be seen in much younger individuals
• Both males and females may be affected
• Individuals of all racial and ethnic background may be affected. Worldwide, no geographical localization has been reported

What are the Risk Factors for Plane Xanthoma? (Predisposing Factors)

• Individuals with increased lipid or triglyceride levels in blood are at risk for developing Plane Xanthoma. The predisposing factors that result in elevated fat levels include:
• Hyperlipidemia
• Hypertriglyceridemia
• Type III dysbetalipoproteinemia
• Conditions causing biliary obstruction or bile duct obstruction
• Use of certain medications
• Poorly-controlled diabetes
• Hypothyroidism
• High-fat diet and a lack of physical activities/exercise
• High BMI levels: Obesity or overweight individuals have a higher risk
• Excess consumption of alcohol

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Plane Xanthoma? (Etiology)

The cause of development of Plane Xanthoma is not well-understood in some cases. In some individuals, it is associated with metabolic disorders that result in abnormal lipid/cholesterol/triglyceride levels in blood.

• Plane Xanthoma develops as a skin manifestation of hypertriglyceridemia, hyperlipidemia, or dysbetalipoproteinemia
• The lipids in blood combine with certain proteins to form water-insoluble lipoproteins, which accumulate beneath the skin to form xanthomas

What are the Signs and Symptoms of Plane Xanthoma?

The signs and symptoms of Plane Xanthoma may include:

• Presence of small macules and papules distributed all over the body
  • A macule is a flat, distinct, discolored area of skin less than 1 cm wide. A macule usually does not involve changes in the thickness or texture of the affected skin
  • A papule is an area of abnormal skin tissue that is less than 1 cm around. Usually a papule has distinct borders, and it can appear in a variety of shapes
• The skin lesions may have a yellowish discoloration
• The lesions are particularly noted around the eyelids, palms of hands, muscles near the joints (arms and legs), on the armpits, head and neck region, and upper trunk including the shoulders
• The lesions are painless and benign

Additional signs and symptoms of the underlying/associated condition may be noted.

How is Plane Xanthoma Diagnosed?

A diagnosis of Plane Xanthoma may involve the following tests and exams:

• A thorough medical history and physical examination
• Liver function test
• Lipid profile test
• Test for blood cholesterol levels
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: A biopsy may be performed to rule out other skin conditions with similar signs and symptoms.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Plane Xanthoma?

The complications of Plane Xanthoma may include:

• The presence of multiple lesions may result in cosmetic concerns and emotional stress
• Scratching the lesions may lead to bleeding and ulceration, which may result in secondary infections. This may give rise to scar formation on healing, in rare cases
• Formation of new lesions at other body sites, or recurrence of xanthomas after treatment
• Increased risk for myeloproliferative disorders
• Complications that arise from the underlying metabolic disorder, if any

How is Plane Xanthoma Treated?

The primary treatment of Plane Xanthoma involves treating the underlying metabolic disorder (if any). The treatment measures may involve:

• Undertaking treatment for any underlying condition causing Plane Xanthoma through:
  • Appropriate diet and exercising
  • Weight control, for obese or overweight individuals; maintaining a healthy weight
  • Prescription oral or intravenously-administered medications
  • Undergo follow-up tests and checkups to ensure that lipid levels are controlled
  • Avoiding or minimizing alcohol intake; quitting smoking
• Treatment of skin lesions may involve (if necessary):
  • Application of topical creams containing trichloroacetic acid (TCA)
  • Laser therapy
  • Surgical excision and removal, if necessary

How can Plane Xanthoma be Prevented?

• Currently, there are no known methods available to prevent the occurrence of Plane Xanthoma
• Having a low-fat diet and adequate physical activities/exercises to maintain optimal weight are beneficial in keeping low triglyceride levels

Regular tests and periodic checkups to monitor the condition are recommended following treatment.

What is the Prognosis of Plane Xanthoma? (Outcomes/Resolutions)

• The prognosis of Plane Xanthoma is good with appropriate treatment
• In many individuals, the lesions disappear with adequate management of the underlying condition

Additional and Relevant Useful Information for Plane Xanthoma:

• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse