XANTHELASMA is generally considered to be the commonest external manifestation of essential hypercholesteremic xanthomatosis1 (familial hypercholesteremia2). Major interest in the xanthomatous lesions centers about their importance with respect to the presence or development of atherosclerotic vascular disease. The purpose of this paper is to report observations of 35 patients with xanthelasma, obtained mainly from the private dermatologic practice of one of us (N. N. E.). It was felt of particular importance to study the serum of such patients with respect to lipoproteins which appear to be in some way associated with atherosclerosis.
The clinical status of these patients was carefully investigated and was supplemented by electrocardiograms and by the thymol turbidity and sulfobromophthalein (bromsulphalein®) sodium tests of liver function. All patients with nonxanthomatous abnormalities known to be associated with a disturbed cholesterol metabolism were excluded. Particular attention was given to the possible presence of manifest arteriosclerotic cardiovascular disease. Quantitative analysis of