Xanthelasma

Hypertrophy of the epithelial lining and adjacent structures of the follicle, with fatty degeneration, is called Xanthelasma, because of the yellow laminae which characterize it. The disease may occur in two forms - "either as tubercles, varying from the size of a pin's head to that of a large pea, isolated or confluent; or secondly, as yellowish patches of irregular outline, slightly elevated, and with but little hardness." These are mere modifications of one disease, but may occur together in the same person. The disease is seen about the face, the ear, and the limbs and palms of the hands. The most common form and seat is a yellowish patching about the inner part of the eye; the disease is symmetrical; the cuticle over the diseased part is unaffected. It never occurs in children; but it is fairly common in middle and senile periods of life. In a small proportion of cases, that are very severe, jaundice with enlargement of the liver is met with. When jaundice occurs, it almost always precedes the xanthelasmic patches. The form of jaundice is peculiar, the skin becoming of an olive brown, or almost black tint, rather than yellow, and the color being remarkable for its long persistence.


Xanthelasma occurs more frequently in females than in males, the proportion being two to one. The patches occur to those who have been liable to have dark areola round the eyes, whether from "sick-headaches", ovarian disturbances, nervous fatigue, pregnancy, or from any other causes. Hence their frequency in bilious subjects, and in the female sex.