Ksantelazma (a flat ksantoma a century) — flat good-quality formation of yellowish color in the form of slightly towering plaque. Settles down more often on an upper eyelid at an internal corner of an eye. Ksantelazma can be single, multiple or be one of manifestations of a ksantomatoz of skin at which similar to a ksantelazma of a plaque settle down also on other parts of the body. Diagnostics is based on appearance of education. At detection of a ksantelazma conduct a research of a lipidic range of blood. At identification of its violations therapy is directed to correction of maintenance of lipids and cholesterol of blood. Make removal of a ksantelazma for elimination of cosmetic defect.
The ksantelazma received the name from the Greek words "xanthos" — golden-yellow and "elasma" — a plate. Aged people and most often women are ill it generally. A number of authors considers that the ksantelazma can be considered as a marker of heavy atherosclerosis and the increased risk of development of a myocardial infarction.
Causes of a ksantelazma
The exact causes of a ksantelazma are not known. Ksantomatoz of skin develops against the background of the broken exchange of fats in an organism and represents local deposits of fats in a sosochkovy layer terms. Though ksantelazma on the structure practically do not differ from a ksant, at their isolated emergence according to analyses often it is not possible to find considerable violations of fatty exchange. Ksantelazma and a ksantoma are often observed at patients with obesity, diabetes, miksedemy, the lipoidny nefroz, pancreatitis, cirrhosis raised by the content of cholesterol in blood.
Ksantomatoz can have the hereditary nature. In such cases genetically caused violation of fatty exchange develops. The disease is shown within the first year of life.
Ksantelazma represents a little acting plaque of yellow color located on an upper eyelid. It is painless at palpation and has a soft consistence. As a rule, ksantelazma appear on both centuries. They can be single and multiple. In the latter case ksantelazma can merge, forming hilly elements. Sometimes ksantelazma merge in the continuous yellow strip with an uneven contour passing through all upper eyelid.
Emergence is characteristic of a ksantelazma sudden, without the previous changes of skin of a century. Its development happens gradually and rather slowly, without bringing to the patient any subjective feelings. Ksantelazma can reach the sizes from a small pea to a large fasolina. It is never exposed to transformation in a malignant new growth and does not pose a threat for a human body. However large and multiple ksantelazma, despite the inoffensiveness from the medical point of view, represent a noticeable cosmetic problem.
If ksantelazma are manifestation of a ksantomatoz, then they often are followed by damage of a lower eyelid on which ksantoma are formed. At the same time ksantoma are localized also on other sites of an integument: face, neck, knee and elbow joints, razgibatelny surface of extremities, buttocks, etc. Their emergence on mucous a soft and hard palate, lips is possible. Ksantoma can be melkouzelkovy (eruptivny), flat in the form of plaques or tuberous in the form of large knots with an uneven surface. Diameter of these educations varies from 2 mm to 5 cm. In some cases ksantoma merge among themselves and there is a formation of a large plaque to a lobular structure.
The arisen ksantoma and ksantelazma remain all life. Gradually they grow in the sizes, their quantity increases.
Emergence and a ksant at small children can be a sign of a hereditary giperkholesterinemichesky ksantomatoz which then is shown by violations from cardiovascular system and a liver, can be followed by formation of bone cysts.
Diagnostics of a ksantelazma
Consultation of the dermatologist and endocrinologist is recommended to patients from ksantelazmy. Characteristic appearance and localization of a ksantelazma allow to make the diagnosis at once after survey of the patient. At survey of a ksantelazma or ksantoma use pressing by subject glass (diaskopiya). Thus try to obtain bleeding of educations that allows to see their yellow color accurately.
Surely conduct a research of lipidic exchange. For this purpose appoint definition of cholesterol in serum of blood and lipoproteid. The differential diagnosis with siringomy, elastichesky psevdoksantomy and tumoral diseases of skin is in certain cases necessary.
Treatment of a ksantelazma
Ksantelazma has no specific treatment. At emergence of a ksantelazma or ksantomatoz against the background of a disease which can be a cause of infringement of fatty exchange treatment of this disease is necessary. According to indications insulin, can be appointed.
Patients with the revealed violation of lipidic composition of blood or increase in cholesterol should adhere to a diet with the lowered content of animal fats. For this purpose animal fats replace vegetable, for example, with sunflower and olive oil. To such patients with ksantelazmy appoint the lipotropny medicines and means reducing the content of cholesterol in blood. Treat them: , , air of nonsaturated fatty acids, lipoic acid, acid tioktovy, , . From phytogenesis medicines possess lipotropny action: birch kidneys, dandelion root, hips, corn rylets, plantain juice, immortelle flowers. It is necessary to remember that these medicines have bile-expelling effect and their application is contraindicated at violations of removal of bile on biliary tract. In treatment of a ksantelazma apply nicotinic and ascorbic acids, cyanocobalamine, a pyridoxine, calcium , it is well-cared chloride.
Surgical treatment is shown for cosmetic reasons. It is carried out by excision of a ksantelazma, its removal by the laser, electrothermic coagulations, cryoinfluences or destructions in the radio wave way. Removal is in most cases made under local anesthesia in out-patient conditions. Small ksantelazma usually delete by means of a diatermokoagulyation. Larger plaques otseparovyvat scissors and tweezers. Edges of a wound reduce and grease with polutorakhloristy iron which forms a strong scab and allows a wound to begin to live primary tension within 1-1,5 weeks. After an otseparovyvaniye with wide foundation of the region of a wound cauterize by a diotermokoagulyation. At a combination with an overhang of a skin fold during a century make their surgical excision together with surplus of skin of an upper eyelid.
For prevention of a redidivirovaniye of a ksantelazma after operation recommend to the patient a dairy and vegetable diet with an exception of animal fats and restriction of carbohydrates. The day norm of butter should not exceed 25 g, sunflower — 75 g.