To the Editor.—
In his comments regarding Jackson's 100-year-old case of "xanthelasma,"1,2 Bernhardt states that hyperlipemic xanthomatosis is unlikely, and I concur with this statement. Indeed, Jackson's use of the term xanthelasma does not tell us what he meant exactly, as the term was frequently used synonymously with xanthoma in the 1890s,3 and the other histiocytic and xanthogranulomatous disorders had generally not yet been described. However, I disagree with Bernhardt's assertion that "a xanthogranulomatous process may be excluded by the lack of mucosal involvement," since a number of possible diagnoses may be entertained in a child with generalized xanthomatousappearing lesions.The chromolithograph that accompanies Jackson's case report clearly shows reddish-brown papular lesions that coalesce into plaques and large sheets. The flexural surfaces and folds of the upper extremities are prominently involved. The mouth and eyelids are not depicted, and Jackson does not tell us whether these areas were
Cropley TG. Jackson's `Remarkable Case of Xanthelasma'. Arch Dermatol. 1991;127(1):123–124. doi:10.1001/archderm.1991.01680010135027
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