The morphologic terms "xanthoma planum" and "xanthelasma" are used to describe cutaneous xanthomas in which the yellow xanthomatous deposits appear as either flat macular areas or slightly elevated plaques. Xanthelasma is the commonest type of skin xanthoma and appears most frequently as localized lesions involving the inner canthi of the eyelids (xanthelasma palpebrarum). More rarely, the neck, trunk, and extremities may be involved.
The lesions represented by these terms are not diagnostic of any underlying abnormality of lipid metabolism, although their presence may suggest such a possibility. They are frequently associated with hypercholesteremia (as in essential familial hypercholesteremia and xanthomatous biliary cirrhosis) and may rarely appear with hyperlipemia (as in idiopathic hyperlipemia). However, flat xanthomas also occur in patients with normal levels of all serum lipids.
About 50% of all patients with localized xanthelasma palpebrarum have normal levels of all serum lipids1 and present no evidence of disturbance of
ALTMAN J, WINKELMANN RK. Diffuse Normolipemic Plane Xanthoma: Generalized Xanthelasma. Arch Dermatol. 1962;85(5):633–640. doi:10.1001/archderm.1962.01590050063012
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