A patient is found to have xanthelasmas on PE. What is the likely diagnosis?

A patient is found to have xanthelasmas on PE. What is the likely diagnosis?

• A. Hypocholesterolemia
• B. Hypertriglyceridemia
• C. Anemia
• D. Hypercholesterolemia

Answer: (D)

Xanthelasmas are yellow plaques on the eyelids made up of lipid-laden macrophages in the skin. Their presence points to a lipid metabolism disorder, most commonly elevated cholesterol with increased LDL. This is why hypercholesterolemia is the best fit, and it prompts checking a lipid profile and assessing cardiovascular risk. Anemia wouldn’t cause these lipid deposits, and while very high triglycerides can be seen with other types of xanthomas, eyelid xanthelasmas are classically associated with high cholesterol rather than isolated hypertriglyceridemia.

Xanthelasmas are yellow plaques on the eyelids made up of lipid-laden macrophages in the skin. Their presence points to a lipid metabolism disorder, most commonly elevated cholesterol with increased LDL. This is why hypercholesterolemia is the best fit, and it prompts checking a lipid profile and assessing cardiovascular risk. Anemia wouldn’t cause these lipid deposits, and while very high triglycerides can be seen with other types of xanthomas, eyelid xanthelasmas are classically associated with high cholesterol rather than isolated hypertriglyceridemia.