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Bajaj S, Orbuch D, Wang JV, Biesman BS, Geronemus RG. Interventional and device treatment of the periocular area. Clin Dermatol 2024; 42:360-372. [PMID: 38336142 DOI: 10.1016/j.clindermatol.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Growth in the research, innovation, and development of laser and energy-based technologies over the past few decades has led to dramatic increases in treatment options for dermatologic and cosmetic concerns of the periorbital area. We highlight recent treatment options using laser and energy-based devices for the clearance of periocular pigmented lesions, including solar lentigines and nevus of Ota; vascular lesions, including port-wine birthmarks, infantile hemangiomas, superficial telangiectasias, and reticular veins; laser ablation of benign tumors, such as xanthelasma; cosmetic rejuvenation; treatment of infraorbital dark circles and festoons; laser removal of eyebrow and eyeliner tattoos; and device-based treatment of chronic dry eyes.
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Affiliation(s)
- Shirin Bajaj
- Laser & Skin Surgery Center of New York, New York, New York, USA
| | - David Orbuch
- Laser & Skin Surgery Center of New York, New York, New York, USA
| | - Jordan V Wang
- Laser & Skin Surgery Center of New York, New York, New York, USA.
| | - Brian S Biesman
- Nashville Centre for Laser and Facial Surgery, Nashville, Tennessee, USA
| | - Roy G Geronemus
- Laser & Skin Surgery Center of New York, New York, New York, USA
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Arora A, Mohta A, Mehta RD, Ghiya BC, Soni P, Jangir VK, Yadav MK, Khokhar R, Mangava V. A Clinical and Dermatoscopic Perspective of the Efficacy and Safety of Erbium: YAG Laser Ablation Versus 50% Trichloroacetic Acid for the Management of Xanthelasma Palpebrarum. J Cutan Aesthet Surg 2024; 17:1-6. [PMID: 38736854 PMCID: PMC11086933 DOI: 10.4103/jcas.jcas_157_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Xanthelasma palpebrarum (XP) is a benign cosmetic condition. Although the role of CO2 laser is well described, there are only a few studies on Erbium: YAG in XP. Similarly, trichloroacetic acid (TCA) is commonly used in XP. However, there are only a few studies comparing these modalities in the treatment of XP. Aim To evaluate the effectiveness and safety of Erbium: YAG laser and 50% TCA in the treatment of XP with the role of dermoscope in the evaluation of lesions. Materials and Methods A total of 20 subjects were randomly allocated into two groups: group A (TCA) and group B (laser). All patients were subcategorized into three grades viz. I (mild), II (moderate), and III (severe) using a self-devised scoring system. Results About 25% and 70% of patients achieved complete clearance in groups A and B, respectively (P = 0.017). The rate of recurrence was 40% and 15% in groups A and B. Dyspigmentation and erythema were the most common side effects. Pretreatment dermoscopic evaluation of the lesion showed a network of brown streaks on a background of a yellowish structureless area and was used to assess the area and margins of the lesion where the adipose tissue was found during the procedure and serial assessment of the lesion.
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Affiliation(s)
- Aakanksha Arora
- Department of Dermatology, Venereology and Leprology, Bikaner, Rajasthan, India
| | - Alpana Mohta
- Department of Dermatology, Venereology and Leprology, Bikaner, Rajasthan, India
| | - Rajesh Datt Mehta
- Department of Dermatology, Venereology and Leprology, Bikaner, Rajasthan, India
| | - Bhikam Chand Ghiya
- Department of Dermatology, Venereology and Leprology, Bikaner, Rajasthan, India
| | - Prasoon Soni
- Department of Dermatology, Venereology and Leprology, Bikaner, Rajasthan, India
| | - Vishnu Kumar Jangir
- Department of Dermatology, Venereology and Leprology, Bikaner, Rajasthan, India
| | - Manoj Kumar Yadav
- Department of Dermatology, Venereology and Leprology, Bikaner, Rajasthan, India
| | - Rajesh Khokhar
- Department of Dermatology, Venereology and Leprology, Bikaner, Rajasthan, India
| | - Vijay Mangava
- Department of Ophthalmology, Sardar Patel Medical College, Bikaner, Rajasthan, India
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Malekzadeh H, Ormseth B, Janis JE. A Practical Review of the Management of Xanthelasma palpebrarum. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4982. [PMID: 37235133 PMCID: PMC10208694 DOI: 10.1097/gox.0000000000004982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/17/2023] [Indexed: 05/28/2023]
Abstract
Xanthelasma palpebrarum is the most common type of xanthomatous lesion. Various methods for treating Xanthelasma palpebrarum have been reported. We conducted a systematic review to evaluate the efficacy and associated complications of different treatment methods, and we summarized these findings as a practical review designed to be clinically useful, accessible, and impactful. Methods The PubMed and Embase databases were searched to identify clinical studies that reported on outcomes and complications of different methods of Xanthelasma treatment. The electronic databases were searched from January 1990 to October 2022. Data on study characteristics, lesion clearance, complications, and recurrences were collected. Results Forty-nine articles (including 1329 patients) were reviewed. The studies reported on surgical excision, laser modalities, electrosurgical techniques, chemical peeling, cryotherapy, and intralesional injection. The majority of studies were retrospective (69%) and single-arm (84%). Surgical excision combined with blepharoplasty and skin grafts showed excellent outcomes for large Xanthelasma. CO2 and erbium yttrium aluminum garnet (Er:YAG) were the most commonly studied lasers and showed more than 75% improvement in over 90% and 80% of patients, respectively. Comparative studies reported better efficacy for CO2 laser than both Er:YAG laser and 30%-50% trichloroacetic acid. Dyspigmentation was the most encountered complication. Conclusions Different methods for the treatment of Xanthelasma palpebrarum have been reported in the literature, with moderate to excellent efficacy and safety profiles depending on the size and location of the lesion. Surgery is more appropriate for larger and deeper lesions, whereas laser and electrosurgical techniques can be used in smaller and more superficial contexts. Only a limited number of comparative studies have been conducted, and novel clinical trials are necessary to further augment appropriate treatment selection.
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Affiliation(s)
- Hamid Malekzadeh
- From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | - Benjamin Ormseth
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jeffrey E. Janis
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Al-Niaimi F. Ultrapulsed CO 2 ablation in the treatment of xanthelasma palpebrarum: high satisfaction treatment with low recurrence. J DERMATOL TREAT 2022; 33:1116-1118. [DOI: 10.1080/09546634.2020.1775776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Firas Al-Niaimi
- 152 Harley Street Clinic, London, UK
- Department of Dermatology, Aalborg University Hospital, Aalborg, Denmark
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Singh A, Tiwary PK, Jha AK, Zeeshan M, Ranjan A. Successful treatment of xanthelasma palpebrarum with a combination of radiofrequency ablation and wound suturing. J Cosmet Dermatol 2020; 19:3286-3290. [PMID: 33459474 DOI: 10.1111/jocd.13678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/05/2020] [Accepted: 08/04/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Xanthelasma palpebrarum is a common disfiguring condition of eyelids often causing cosmetic concern and psychological distress. Various treatment modalities have been used to clear the lesions but none have been found to be fully satisfactory. AIMS To evaluate a novel combination of radiofrequency (RF) ablation and primary wound closure for treatment of xanthelasma palpebrarum (XP). METHODS Forty-five patients were selected after clinical examination and grading of lesions. Radiofrequency ablation was used to remove the lesion followed by suturing of the wound. Efficacy of treatment was evaluated on the basis of clinical examination and photographic images. RESULTS Excellent response was seen in all patients. Of these, in 43 patients complete clearance could be achieved in a single sitting. In the other 2, an additional sitting of RF was done because of the presence of either multiple lesions or significant projection from the main lesion. Recurrence was seen in only two patients at the end of one year. CONCLUSION Radiofrequency removal combined with wound closure showed excellent response with good cosmetic result, no scarring, and rare relapse at end of 1 year. This was achieved in 43(96%) of the total 45 patients in a single sitting.
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Affiliation(s)
- Anupama Singh
- Department of Skin and VD, Patna Medical College and Hospital, Patna, India
| | | | - Abhijeet Kumar Jha
- Department of Skin and VD, Patna Medical College and Hospital, Patna, India
| | - Md Zeeshan
- Department of Skin and VD, Patna Medical College and Hospital, Patna, India
| | - Amit Ranjan
- Department of Skin and VD, Patna Medical College and Hospital, Patna, India
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Al-Kady NAS, Hamdino M, Abdel Kawy FAW. Fractional CO 2 laser versus trichloroacetic acid 50% for xanthelasma palpebrarum therapy. J Cosmet Dermatol 2020; 20:763-768. [PMID: 32892481 DOI: 10.1111/jocd.13666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although being a benign lesion, xanthelasma palpebrarum (XP) causes cosmetic concerns. There are numerous therapeutic methods for XP with adverse events for each method. AIMS Evaluate the safety, efficacy, and downtime of fractional CO2 laser (10 600 nm) versus 50% trichloroacetic acid (TCA) in XP therapy. PATIENTS/METHODS Comparative interventional prospective study involved 20 adult patients with XP. Each patient received a split-face therapy where xanthelasma lesions treated with fractional CO2 laser on the one side and TCA 50% on the other side for maximum 5 sessions with 2-week intervals in between. RESULTS Statistically significant improvement in lesion color, thickness, and size by both fractional CO2 and TCA 50%, with nonstatistically significant difference between both therapeutic modalities after treatment, although downtime, number of sessions, and patient's satisfaction were significantly better for fractional CO2 laser. CONCLUSION Fractional CO2 laser (10 600 nm) is ideal for treatment of xanthelasma because it is safe and effective with short downtime, more patient satisfaction, less sessions, and less complications compared with chemical peeling using TCA (50%).
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Affiliation(s)
- Nissreen Al-Sayed Al-Kady
- Dermatology and Venereology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
| | - Mervat Hamdino
- Dermatology and Venereology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
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Sousa-Neves F, Cardoso da Costa J, Braga J, Prazeres S. Treatment of benign eyelid lesions with Nd:YVO laser: a prospective study. J COSMET LASER THER 2020; 22:146-149. [PMID: 32496946 DOI: 10.1080/14764172.2020.1767787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this prospective cohort study, including consecutively selected patients, was to evaluate the outcomes of Nd:YVO laser-assisted photocoagulation for the removal of benign eyelid lesions. An emulsion of lidocaine and prilocaine was used for dermal analgesia and subcutaneous injection of 2% lidocaine was performed as needed. Follow-up included two visits, at day 15 and 45 postoperatively, in order to assess time of wound healing, postoperative complications, need for additional treatment, and patient's satisfaction. A total of 101 lesions of 66 patients were included, with a mean age of 55.4 ± 15.3 years. All patients were Caucasian and 62% were female. Papilloma was the most common lesion identified (61%). No major complications were reported during and after the procedure. Complete epithelization occurred in 82% and 100%, at the 15 and 45-day visit, respectively. All patients were satisfied with the cosmetic result. Only one patient was proposed for additional therapy during the follow-up period. In conclusion, this study supports Nd:YVO laser-assisted treatment as an effective and safe alternative to conventional surgery for the removal of benign eyelid lesions. The technique is well accepted, easy to perform, and provides excellent cosmetic and functional results.
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Affiliation(s)
- Filipe Sousa-Neves
- Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho , Vila Nova de Gaia, Portugal
| | - João Cardoso da Costa
- Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho , Vila Nova de Gaia, Portugal
| | - Joana Braga
- Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho , Vila Nova de Gaia, Portugal
| | - Sandra Prazeres
- Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho , Vila Nova de Gaia, Portugal
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Zhimin W, Hui W, Fengtao J, Wenjuan S, Yongrong L. Clinical and serum lipid profiles and LDLR genetic analysis of xanthelasma palpebrarum with nonfamilial hypercholesterolemia. J Cosmet Dermatol 2020; 19:3096-3099. [PMID: 32176424 DOI: 10.1111/jocd.13366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND XP is a flat xanthoma that usually presents as bilateral, symmetrical, soft, yellowish papules over the eyelids. The etiology of XP is unknown, but it may be related to complex heterozygous mutations. AIMS To investigate the lipid profiles, important clinical characteristics, and low-density lipoprotein receptor (LDLR) gene mutation in the patients suffering from xanthelasma palpebrarum (XP) with nonfamilial hypercholesterolemia. PATIENTS/METHODS The prospective study included 25 individuals of XP with nonfamilial hypercholesterolemia, and 30 controls neither with XP nor familial hypercholesterolemia (FH). Each one underwent detailed clinical examination, serum lipid profile, and LDLR gene detection at the 400th exon and the 1246th exon. RESULTS In our study, patients with XP were often not present with FH and family history. The mean serum cholesterol (CHOL) (5.20 ± 1.82) and the prevalence of carotid atherosclerosis (4.34 ± 0.78) were significantly higher in study group, while there was no statistically significant difference between two groups in terms of triglyceride (TG) (P = .38) and low-density lipoprotein (LDL) (P = .23). Unusually, the mean levels of high-density lipoprotein (HDL) (1.59 ± 0.31) in the study group were much higher than the controls (1.31 ± 0.30), and the LDLR gene mutation was not found. CONCLUSION Clinical and serum lipid profiles indicated that XP was sporadic and underlying lipid abnormalities especially higher HDL. XP did not occur with mutations in the LDLR gene at the two exons. We suggested too high HDL level may be contributed to pathogenesis of XP and XP is often not associated with FH.
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Affiliation(s)
- Wang Zhimin
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
| | - Wang Hui
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
| | - Ji Fengtao
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
| | - Sun Wenjuan
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
| | - Li Yongrong
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
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Khode S, Tan SHT, Tan EPA, Uppal S. Xanthelasma Palpebrarum: More than Meets the Eye. Indian J Otolaryngol Head Neck Surg 2019; 71:439-446. [PMID: 31742000 DOI: 10.1007/s12070-018-1345-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 04/05/2018] [Indexed: 10/17/2022] Open
Abstract
Xanthelasma palpebrarum (XP) is the most common form of cutaneous xanthomata, and is important aesthetically, because of its close relation to the eyes, as well as medically for its association with cardiovascular disease (CVD). To provide avant-garde review discussing the various aspects of XP, including its aetio-pathogenesis and various treatment modalities. A structured Pubmed and Medline were searched for relevant articles. The finding of recent research has strongly espoused the link between XP and CVD, and mechanisms have been suggested for its formation. The new technologies have led to a multitude of treatment options for XP. XP is a multi-faceted entity; other than simple treatment of the cosmetic aspect of the disease, one must be cognizant of its cardiovascular implications.
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Affiliation(s)
- Shailesh Khode
- Department of Otolaryngology - Head and Neck Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Yishun, 768828 Singapore
| | - Soon Heng Terry Tan
- Department of Otolaryngology - Head and Neck Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Yishun, 768828 Singapore
| | - En-Pei Amanda Tan
- Department of Otolaryngology - Head and Neck Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Yishun, 768828 Singapore
| | - Sandeep Uppal
- Department of Otolaryngology - Head and Neck Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Yishun, 768828 Singapore
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Baroni A. Long‐wave plasma radiofrequency ablation for treatment of xanthelasma palpebrarum. J Cosmet Dermatol 2018; 18:121-123. [DOI: 10.1111/jocd.12509] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Adone Baroni
- Department of Dermatology and Venereology University of Campania “Luigi Vanvitelli” Napoli Italy
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Lee SM, Lew H. Clinical Characteristics of Xanthelasma Palpebrarum and Clinical Effects of Upper Blepharoplasty with Local Flap Technique. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.9.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sang Min Lee
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Helen Lew
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Abstract
Xanthelasmas are localized accumulation of lipid deposits on the eyelids. Lesions are typically asymptomatic and treatment is often sought for cosmetic purposes. Unfortunately, there is paucity of strong evidence in the literature for the effective treatment of normolipidemic xanthelasmas. A literature search using the term “xanthelasma” was carried out in PubMed and Medline databases. Only articles related to treatment were considered and analyzed for their data. Commonly cited treatments include topical trichloroacetic acid, liquid nitrogen cryotherapy, and various lasers including carbon dioxide, Er:YAG, Q-switched Nd:YAG, and pulse dye laser. However, traditional surgical excision has also been used. This article reviews these currently accepted modalities of treatment.
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Affiliation(s)
- Zainab Laftah
- King's College Hospital, Dermatology department, Denmark Hill, London SE5 9RS, UK
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Abstract
Xanthelasma palpebrarum is the most common cutaneous xanthoma, characterized by yellowish plaques over eyelids – most commonly, over the inner canthus of the upper lid. It is triggered by hyperlipidemia, thyroid dysfunction, and diabetes mellitus. Xanthelasma results from perivascular infiltration of mono- and multinucleated foam cells within lipid-laden cytoplasmic vacuoles in the superficial reticular dermis. Different modalities of treatment, such as simple surgical excision, cryotherapy, chemical peeling with trichloroacetic acid, radiofrequency, and laser, are used in the treatment of xanthelasma palpebrarum. A brief review of current treatment strategies is presented here.
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Affiliation(s)
- Pragya A Nair
- Department of Dermatology, Venereology and Leprosy, Pramukhswami Medical College, Gujarat, India
| | - Rochit Singhal
- Department of Dermatology, Venereology and Leprosy, Pramukhswami Medical College, Gujarat, India
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Hu H, Gao Y, Tang J, Zhao Y, Wang H, Jiang H. Effect of a high-cholesterol diet on lipoprotein metabolism and xanthoma formation in rabbits. J Cosmet Dermatol 2017; 17:885-888. [PMID: 29024285 DOI: 10.1111/jocd.12428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Xanthelasma is the most common type of cutaneous xanthoma and often occurs on the eyelids. Xanthoma has been reported to be highly correlated with abnormal lipoprotein metabolism. AIMS In this study, we wanted to investigate the effects of a high-cholesterol diet on xanthoma formation and lipoprotein metabolism in rabbits. METHODS In animals fed with high-cholesterol diet, deteced plasma lipid [ie, total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (L-DLC)] levels and pathology of xanthoma. RESULTS Plasma lipid levels were dramatically elevated within 8 weeks. In addition, high dietary cholesterol promoted xanthoma formation on the napex. Microscopic examination showed that foam cells laden with cholesterol deposits accumulated around the dermal capillaries and cutaneous appendages within the skin of the napex. CONCLUSION These findings indicate a critical role for a high-cholesterol diet in the dysregulation of lipoprotein metabolism and the development of xanthoma in rabbits. The results suggest that abnormal lipid metabolism may increase the occurrence of xanthoma.
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Affiliation(s)
- Hao Hu
- Department of Plastic and Reconstructive Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.,The Hospital of Beijing Armed Police Forces, Beijing, China
| | - Yak Gao
- Department of Plastic and Reconstructive Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jing Tang
- The Second Hospital of Beijing Armed Police Forces, Beijing, China
| | - Yaozh Zhao
- Department of Plastic and Reconstructive Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Hui Wang
- Department of Plastic and Reconstructive Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Hua Jiang
- Department of Plastic and Reconstructive Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Zhang J, Duan J, Gong L. Super pulse CO 2 laser therapy for benign eyelid tumors. J Cosmet Dermatol 2017; 17:171-175. [PMID: 28834156 DOI: 10.1111/jocd.12375] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Benign eyelid tumors occur commonly in daily outpatient services. OBJECTIVES The aim of this study was to evaluate the treatment of benign eyelid lesions with a super pulse CO2 laser as an alternative to surgical excision. METHODS This retrospective clinical study included 80 patients with 99 benign eyelid lesions treated with super pulse CO2 laser photocoagulation. The following areas were involved: the upper eyelid in 38 cases, the lower eyelid in 39 cases, and the angulus oculi in seven cases (the eyelid margin was included in 18 cases). The laser spot size ranged from 120 to 200 μm and the super pulse CO2 laser power density varied between 0.6 and 21.1 W/mm2 . The mean follow-up period was 14.0±7.1 months (range five to 30). Histological diagnoses were obtained in 62 of the 80 patients. RESULTS The cosmetic outcomes of all of the patients were satisfactory after treatment, and the wounds formed dry scabs, with no infections. They were epithelialized within 2-4 weeks with normal-appearing epithelium. Temporarily, the treated area had less hyperpigmentation than the surrounding normal skin, showing no obvious scars or notches. No complications were observed, with no relapses during the follow-up. CONCLUSIONS The super pulse CO2 laser therapy of the benign eyelid tumors provided satisfactory cosmetic results in this study. It is a convenient, cheap, accessible, and well-tolerated alternative to traditional surgery, especially for diffuse tumors, or those positioned close to the lacrimal papillae.
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Affiliation(s)
- Jing Zhang
- Department of Laser Plastic Surgery, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Jueni Duan
- Department of Laser Plastic Surgery, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Lan Gong
- Department of Laser Plastic Surgery, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.,Department Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
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Heng JK, Chua SH, Goh CL, Cheng S, Tan V, Tan WP. Treatment of xanthelasma palpebrarum with a 1064-nm, Q-switched Nd:YAG laser. J Am Acad Dermatol 2017; 77:728-734. [PMID: 28666611 DOI: 10.1016/j.jaad.2017.03.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/19/2017] [Accepted: 03/26/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Xanthelasma palpebrarum is the most common cutaneous xanthoma characterized by soft, yellow papules or plaques that arise on the periorbital skin. As these lesions can be cosmetically disfiguring, many patients seek medical help to remove these lesions. OBJECTIVE To determine the effectiveness and minimum number of treatment sessions with a 1064-nm, Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the treatment of xanthelasma. METHODS A retrospective review of patients with xanthelasma consecutively treated with Q-switched Nd:YAG laser was conducted. Forty-six patients with 103 lesions were identified from January 2012 through August 2015. Photographs taken of patients immediately before treatment and 4-8 weeks after treatment were independently evaluated by 2 dermatologists. RESULTS After a single treatment session, 93.2% of lesions had some degree of clearance. All lesions had excellent-to-complete clearance after at least 4 treatment sessions. Patients usually required 4 treatment sessions for optimal results. LIMITATIONS This was a retrospective study. Treatment parameters varied, follow-up periods were not uniform, and response was not assessed with a validated scale. CONCLUSION The Q-switched Nd:YAG laser is effective and well tolerated in the treatment of xanthelasma in our study population.
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Nguyen AH, Vaudreuil AM, Huerter CJ. Systematic review of laser therapy in xanthelasma palpebrarum. Int J Dermatol 2017; 56:e47-e55. [DOI: 10.1111/ijd.13534] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 10/24/2016] [Accepted: 11/14/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Austin H. Nguyen
- Division of Dermatology; Creighton University School of Medicine; Omaha NE USA
| | - Adam M. Vaudreuil
- Division of Dermatology; Creighton University School of Medicine; Omaha NE USA
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Balevi A, Ustuner P, Ozdemir M. Erbium:yttrium aluminum garnet laser versus Q-switched neodymium:yttrium aluminum garnet laser for the treatment of xanthelasma palpebrarum. J COSMET LASER THER 2016; 19:100-105. [PMID: 27849400 DOI: 10.1080/14764172.2016.1256488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Several lasers have been used for the treatment of xanthelasma palpebrarum (XP), such as Q-switched neodymium:yttrium aluminum garnet (QSNd:YAG) and erbium:yttrium aluminum garnet (Er:YAG) laser. Up to now, a comparative study among these laser options in the treatment of XP has not been reported. OBJECTIVE The aim of this study was to compare the clinical efficacy and response rates of QSNd:YAG and Er:YAG in the treatment of XP. METHODS Sixty patients with a total of 102 XP lesions were randomly and equally divided into two groups. The first group was treated with QSNd:YAG at a fluence of 10 joule/cm2, 10 Hz and 2 mm spot size, and the second group was treated with Er:YAG at 200-300 millijoule, 4 Hz and 2 mm spot size. RESULTS In the Er:YAG group, the percentage of patients who required 3 or 4 sessions and wound healing time were higher compared to those of the QSNd:YAG group. Furthermore, the percentage of patients who had an improvement score of 4 was higher in the Er:YAG than that in the QSNd:YAG group. CONCLUSION Er:YAG is an efficient, successful and minimally invasive method without long-lasting adverse effects.
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Affiliation(s)
- Ali Balevi
- a Department of Dermatology, School of Medicine , Istanbul Medipol University , Istanbul , Turkey
| | - Pelin Ustuner
- a Department of Dermatology, School of Medicine , Istanbul Medipol University , Istanbul , Turkey
| | - Mustafa Ozdemir
- a Department of Dermatology, School of Medicine , Istanbul Medipol University , Istanbul , Turkey
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Kavoussi H, Ebrahimi A, Rezaei M, Ramezani M, Najafi B, Kavoussi R. Serum lipid profile and clinical characteristics of patients with xanthelasma palpebrarum. An Bras Dermatol 2016; 91:468-71. [PMID: 27579742 PMCID: PMC4999105 DOI: 10.1590/abd1806-4841.20164607] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 09/04/2015] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Although many factors are involved in the etiology of xanthelasma palpebrum, lipid disorder is strongly associated with its induction. Xanthelasma palpebrum, the most common type of xanthoma, usually presents in middle-aged females and results in aesthetic problems. OBJECTIVE To evaluate thelipid profile and important clinical aspects of xanthelasma palpebrum patients. METHODS In this descriptive study, we enrolled 42xanthelasma palpebrumpatients, and 42 cases of non-inflammatory skin disorders as thecontrol group, matched for age and gender.The clinical characteristics of the patients and fasting serum lipid profile were recorded for both groups. The data obtained were analyzed using SPSS-16. RESULTS Xanthelasma palpebrum was found more commonly in middle-aged females with disease onset of less than 1 year, and without significant familial history of xanthoma. Furthermore,xanthelasma lesionswere most often seen in the upper lid with mild extension and was rarely associated with systemic disease. There was no statistically significant difference between two groups regarding hypertriglyceridemia (p= 0.231) and hypercholesterolemia (p= 0.302). The mean serum levels of cholesterol (221.51±60.4 mg/dl), triglyceride (185.98±71.1 mg/dl) and VLDL (37.7±17.6 mg/dl) were significantly higher and themedian HDL (36.2 (31, 41) mg/dl) level was lower in thepatient group. CONCLUSION In our study, hypercholesterolemia and hypertriglyceridemia did not reveal a significant difference between thepatient and control groups; however, mean serum values for cholesterol, triglyceride, VLDL and HDL showed a significant difference between the two groups. Therefore, in addition to lipid abnormality, other factors could be involved in the pathogenesis of xanthelasma palpebrum.
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Affiliation(s)
| | - Ali Ebrahimi
- Kermanshah University of Medical Sciences -
Kermanshah, Iran
| | - Mansour Rezaei
- Kermanshah University of Medical Sciences -
Kermanshah, Iran
| | | | - Behnaz Najafi
- Kermanshah University of Medical Sciences -
Kermanshah, Iran
| | - Reza Kavoussi
- Kermanshah University of Medical Sciences -
Kermanshah, Iran
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Continuous Wave Potassium Titanyl Phosphate Laser Treatment is Safe and Effective for Xanthelasma Palpebrarum. Dermatol Surg 2016; 42:860-6. [PMID: 27227474 DOI: 10.1097/dss.0000000000000772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although not an accepted standard treatment, the 532-nm continuous wave potassium titanyl phosphate (CW-KTP) laser might be a powerful device to treat xanthelasma palpebrarum (XP). OBJECTIVE To determine the safety and efficacy of CW-KTP laser treatment for XP. MATERIALS AND METHODS Between January 2013 and January 2015, 30 consecutive patients with XP were treated with a 532-nm CW-KTP laser (spot size: 0.9 mm, power: 5.0 W, fluence: 36-38 J/cm, pulse width: 46 milliseconds, frequency: 2.0 Hz, passes per session: 3). In a retrospective study design, safety and efficacy data were collected and analyzed. RESULTS Overall, 29/30 (97%) of patients had an excellent cosmetical result. Downtime was 1 week with crusted lesions. Although slight hypopigmentation was common, only 1/30 (3%) patients had hypopigmentation that was more than expected. Recurrences (13/30; 43%) were frequent, so that yearly maintenance therapy was warranted. No major side effects were noticed. CONCLUSION Continuous wave KTP laser therapy is safe and highly effective for XP, although regular follow-up treatments are often necessary to maintain the achieved cosmetic results.
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Abstract
BACKGROUND Xanthelasma palpebrarum (xanthelasma) is the most common type of cutaneous xanthoma, and many patients tend to seek medical treatments for cosmetic reasons. Many methods treating xanthelasma have been proposed, but none of these options can be regarded as a perfect solution. OBJECTIVE To study and evaluate the intralesional injection treatment of xanthelasma with pingyangmycin, which has been widely used as a broad-spectrum antitumor antibiotic. MATERIALS AND METHODS 21 lesions in 12 patients were treated by intralesional pingyangmycin. Photographs were taken before and after each treatment session. Patients were followed up for 7 to 36 months. RESULTS All patients except one received satisfactory results after up to 2 sessions. Only 1 patient had a local recurrence 1 year after the treatment. No severe complications such as infection, atrophy, ulceration, or scar were noticed. CONCLUSION Intralesional pingyangmycin is a cheap, effective, and safe treatment for xanthelasma, which has been well accepted by patients.
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Abstract
Advances in laser technology in recent decades have increased the options for the treatment of dermatologic conditions of the eye and eyelid. Benign tumors can be laser-ablated with relative ease, and vascular and melanocytic lesions can be precisely targeted with modern lasers. In this contribution, we review treatment of periocular pigmented lesions, including melanocytic nevi and nevus of Ota; vascular lesions including telangiectasias, port wine stains, and infantile hemangiomas; hair removal; eyeliner tattoo removal; laser ablation of common benign periocular tumors, such as syringomas, xanthelasma, milia, and seborrheic keratoses; and laser resurfacing. The recent advent of fractionated laser technology has resulted in dramatically decreased healing times for periocular skin resurfacing and fewer adverse effects. Fractionated laser resurfacing has now nearly supplanted traditional full-field laser resurfacing, and safe treatment of rhytides on the thin skin of the eyelids is possible. Proper eye protection is, of course, essential when using lasers near the eye. Patient preparation, safety precautions, and risks--intraocular and extraocular--are discussed herein. As laser technology continues to advance, we are sure to see improvements in current treatments, as well as development of new applications of cutaneous lasers.
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Affiliation(s)
- Breton Yates
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, Farmington, Connecticut
| | - Syril Keena T Que
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, Farmington, Connecticut
| | - Logan D'Souza
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, Farmington, Connecticut
| | - Jeanine Suchecki
- Division of Ophthalmology, University of Connecticut Health Center, Department of Surgery, 263 Farmington Avenue, Farmington, Connecticut
| | - Justin J Finch
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, Farmington, Connecticut.
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Pathania V, Chatterjee M. Ultrapulse carbon dioxide laser ablation of xanthelasma palpebrarum: a case series. J Cutan Aesthet Surg 2015; 8:46-9. [PMID: 25949023 PMCID: PMC4411593 DOI: 10.4103/0974-2077.155084] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Context: Xanthelasma palpebrarum is the most common form of xanthomas. Albeit a benign entity, it is cosmetically disturbing and a frequently recurring dermatologic referral. Although the classical treatment option remains surgical excision, alternatively, chemical cauterization, cryosurgery and electrofulguration have all been tried in the past with mixed results. The use of laser systems such as carbon dioxide laser, Erb:YAG laser, Q-switched Nd:YAG laser, diode laser, pulsed dye laser and KTP laser have become popular in the treatment of these lesions. Recent literature suggests minimal pigmentary changes and scarring with the use of ultrapulse carbon dioxide laser treatment of these lesions. Aim: To study and evaluate the effectiveness of ultrapulse carbon dioxide laser ablation for treatment of xanthelasma palpebrarum. Materials and Methods: 10 patients presenting with bilateral xanthelasma palpebrarum, new and with recurrence were studied for results after a single treatment with ultrapulse carbon dioxide laser (10,600 nm; 100-200 Hz; 200-400 μsec). The follow-up time was 9 months. Results: All lesions were treatable with a single-laser treatment session. Two patients (20%) developed recurrence during the follow-up period. Side effects included post inflammatory hyperpigmentation in two patients (20%), but no visible scarring was observed. Conclusions: The ultrapulse carbon dioxide laser is an effective and safe therapeutic alternative in treatment of xanthelasma palpebrarum.
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Affiliation(s)
- Vikas Pathania
- Department of Dermatology, Military Hospital, Bareilly, Uttar Pradesh, India
| | - Manas Chatterjee
- Department of Dermatology, Command Hospital, Kolkata, West Bengal, India
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Abdelkader M, Alashry SE. Argon laser versus erbium:YAG laser in the treatment of xanthelasma palpebrarum. Saudi J Ophthalmol 2015; 29:116-20. [PMID: 25892929 PMCID: PMC4398792 DOI: 10.1016/j.sjopt.2014.09.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 07/22/2014] [Accepted: 09/17/2014] [Indexed: 11/19/2022] Open
Abstract
Background Xanthelasma palpebrarum is the most common of the xanthomas with asymptomatic, symmetrical, bilateral, soft, yellow, polygonal papules around the eyelids. Though it is a benign lesion causing no functional disturbance, it is esthetically annoying. The surgical laser offers an extremely elegant and powerful solution to this problem. Objective To evaluate the effectiveness of erbium:YAG and argon lasers in the treatment of xanthelasma lesions. Patients and methods Forty patients were included in the study. Twenty patients (15 patients were bilateral with 30 eyes either in the upper or lower lid and 5 patients were unilateral) were treated with erbium:YAG laser. Another 20 patients (10 patients were bilateral with 20 eyes and 10 patients were unilateral) were treated with argon laser. Results In the majority of treated patients (either treated with erbium:YAG or argon laser), xanthelasma lesions were completely disappeared or significantly decreased in size. Two patients showed pigmentary changes in the form of hypopigmentation with erbium:YAG laser (one case), another case showed hyperpigmentation. No intraoperative complication was observed. No significant scar or recurrence was observed. Conclusion Argon laser in xanthelasma is an easy, effective, and safe method of treatment for small lesions and YAG laser is more better for large lesions than argon laser.
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Affiliation(s)
- Mona Abdelkader
- Department of Ophthalmology (Mansoura Ophthalmic Center), Mansoura University, Egypt
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Korkmaz Ş, Ekici F, Sül S. Argon laser-assisted treatment of benign eyelid lesions. Lasers Med Sci 2015; 30:527-31. [DOI: 10.1007/s10103-014-1708-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 12/22/2014] [Indexed: 11/28/2022]
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Fractional CO2 Laser Is an Effective Therapeutic Modality for Xanthelasma Palpebrarum. Dermatol Surg 2014; 40:1349-55. [DOI: 10.1097/dss.0000000000000172] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Successful Cosmetic Ablation of Xanthelasma Palpebrarum With Low-Voltage Radiofrequency. Dermatol Surg 2014; 40:1443-4. [DOI: 10.1097/dss.0000000000000186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Outcomes of surgical management of xanthelasma palpebrarum. Arch Plast Surg 2013; 40:380-6. [PMID: 23898435 PMCID: PMC3723999 DOI: 10.5999/aps.2013.40.4.380] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 03/17/2013] [Accepted: 05/27/2013] [Indexed: 11/30/2022] Open
Abstract
Background Xanthelasma palpebrarum (XP) is a benign disorder manifesting as yellowish cholesterol-laden plaques on the eyelids. This paper presents the outcomes in patients with XP who have undergone surgical excision as the main modality of treatment. Methods A retrospective review of patients who received surgery for xanthelasma palpebrarum from March 2007 to March 2011 was conducted. Patients were classified into four grades according to the location and extent of the lesion, with grade I being the mildest and grade IV being the most diffuse. Simple excision was performed in grade I and II lesions, while local flaps and skin grafts were performed in the more advanced grades. Results Ninety-five cases from March 2007 to March 2011 were included in this study. 66 cases (70%), were treated by simple excision. Twenty-four cases (25%) and 5 cases (5%) were treated by simple excision in combination with or without local flaps and skin grafts. In approximately 1/4 of the patients, orbicularis oris muscle involvement was observed. 4 patients (4.2%) developed scar contracture postoperatively, which required a secondary procedure. Recurrence was reported in 3 patients (3.1%). Otherwise. There were no other reports of major complications or disfigurement. Conclusions We found that for lesions involving the deep dermis and/or muscle, surgical excision was the most appropriate therapeutic option.
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Güngör Ş, Canat D, Gökdemir G. Erbium: YAG laser ablation versus 70% trichloroacetıc acid application in the treatment of xanthelasma palpebrarum. J DERMATOL TREAT 2013; 25:290-3. [PMID: 23441855 DOI: 10.3109/09546634.2013.777153] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Şule Güngör
- Dermatology Department, Okmeydanı Training and Research Hospital,
Istanbul, Turkey
| | - Dilek Canat
- Dermatology Department, Istanbul Training and Research Hospital,
Istanbul, Turkey
| | - Gonca Gökdemir
- Dermatology Department, Okmeydanı Training and Research Hospital,
Istanbul, Turkey
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Klein A, Bäumler W, Landthaler M, Babilas P. Laser thermal therapy of benign skin tumours: Review and update. Int J Hyperthermia 2011; 27:762-70. [DOI: 10.3109/02656736.2011.599049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Park EJ, Youn SH, Cho EB, Lee GS, Hann SK, Kim KH, Kim KJ. Xanthelasma palpebrarum treatment with a 1,450-nm-diode laser. Dermatol Surg 2011; 37:791-6. [PMID: 21605240 DOI: 10.1111/j.1524-4725.2011.01945..x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Various treatments of xanthelasma palpebrarum have been studied, including surgical excision, treatment with chemicals, and ablative laser therapy, but these methods have some disadvantages. Recently, nonablative laser therapy has been proposed as a treatment for xanthelasma palpebrarum. OBJECTIVE To investigate the efficacy and safety of a 1,450-nm-diode laser in the treatment of xanthelasma. MATERIALS AND METHODS Sixteen patients were treated using a 1,450-nm-diode laser. Fluences of 12 J/cm(2) , a 6-mm spot size, and a dynamic cooling device setting of 20 to 30 ms were used. One to four treatments 4 to 6 weeks apart were given to each patient. Photographs were taken before each treatment session and 4 to 6 weeks after the last treatment. RESULTS Two (12.5%), eight (50%), and four (25%) of the 16 patients were scored as having some (20-40% clearing), moderate (40-60% clearing), and marked (60-80% clearing) improvement, respectively. Focal mild transient hyperpigmentation was noted in five patients. Post-treatment local swelling lasted 3 to 4 days. CONCLUSION The 1,450-nm-diode laser treatment is a new, valuable treatment option for xanthelasma palpebrarum, offering relatively mild side effects. Studies including long term follow up and a comparison with alternative treatment modalities are necessary to further assess the clinical utility of this treatment. The authors have indicated no significant interest with commercial supporters.
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Affiliation(s)
- Eun Joo Park
- Department of Dermatology, College of Medicine, Hallym University, Anyang-si, Gyeonggi-do, Korea Drs Woo and Hann's Skin and Laser Center, Seoul, Korea
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Karsai S, Czarnecka A, Raulin C. Treatment of Xanthelasma Palpebrarum Using a Pulsed Dye Laser. Dermatol Surg 2010; 36:610-7. [DOI: 10.1111/j.1524-4725.2010.01514.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cannon PS, Ajit R, Leatherbarrow B. Efficacy of trichloroacetic acid (95%) in the management of xanthelasma palpebrarum. Clin Exp Dermatol 2010; 35:845-8. [DOI: 10.1111/j.1365-2230.2010.03818.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Karsai S, Schmitt L, Raulin C. Is Q-Switched Neodymium-Doped Yttrium Aluminium Garnet Laser an Effective Approach to Treat Xanthelasma Palpebrarum? Results from a Clinical Study of 76 Cases. Dermatol Surg 2009; 35:1962-9. [DOI: 10.1111/j.1524-4725.2009.01314.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Elabjer BK, Busić M, Sekelj S, Krstonijević EK. Operative treatment of large periocular xanthelasma. Orbit 2009; 28:16-9. [PMID: 19229739 DOI: 10.1080/01676830802418872] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To present our experience in operative treatment of large periocular xanthelasma. METHODS Sixty-three patients with large periocular xanthelasma were operatively treated in our department. Ipsilateral and/or contralateral lid skin grafts harvested by blepharoplasty, alone or in combination with local flaps, were used. Forty patients (64%) had enough skin to graft the defect after primary xanthelasma removal. In 10 patients, additional local flaps were used: modified rhomboid flap in six patients, local advancement flap in two, and bi-lobed flap in two patients. In three patients (5%), a sequential approach was applied since xanthelasma were too large to be completely removed in a single-step excision. No serious complications were shown. RESULTS Patients were followed from 6 months to 8 years. Five patients (8%) returned with recurrences 3-8 years after primary excision. CONCLUSIONS In lack of the setting for xanthelasma laser treatment, operative approach of a single-step or sequential excision using lid skin graft combined with local flaps proved its value for large periocular xanthelasma.
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Fusade T. Treatment of xanthelasma palpebrarum by 1064-nm Q-switched Nd:YAG laser: a study of 11 cases. Br J Dermatol 2007; 158:84-7. [DOI: 10.1111/j.1365-2133.2007.08194.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Berger C, Kopera D. KTP-Laser-Koagulation bei Xanthelasma palpebrarum. KTP laser coagulation for xanthelasma palpebrarum. J Dtsch Dermatol Ges 2005; 3:775-9. [PMID: 16194155 DOI: 10.1111/j.1610-0387.2005.05746.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Xanthelasma palpebrarum is a benign skin disorder of unknown etiology appearing as one or multiple yellowish plaques around the eyelids. Hyperlipidemia, thyroid dysfunction, and diabetes mellitus are possible pathogenetic triggers. Removal of xanthelasma is desired for aesthetic reasons. While there are many treatment options, search continue for newer methods with less scarring and post-inflammatory hyperpigmentation. PATIENTS AND METHODS We employed for the first time KTP laser (532 nm) for the treatment of 14 patients with xanthelasma palpebrarum on 33 eyelids. RESULTS More than 70% of the patients tolerated KTP laser irradiation without any analgesia. 85.7% showed respectable reduction of xanthelasma palpebrarum after one to three treatment sessions without side effects. CONCLUSIONS KTP laser irradiation represents a minimally invasive, safe and effective treatment option for the reduction of xanthelasma palpebrarum without undesired side effects.
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