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Xanthelasma palpebrarum Homeopathic Treatment



Xanthelasma (or xanthelasma palpebrarum) is a sharply demarcated yellowish collection of cholesterol underneath the skin, usually on or around the eyelids. Although not harmful or painful, these minor growths may be disfiguring and can be removed. The plural is "xanthelasmata". They are common in people of Asian origin and those from the Mediterranean region. Xanthelasmata can be removed with trichloroacetic acid peel, surgery, lasers or cryotherapy. Removal can cause scarring and pigment changes, but it is unusual after treatment with trichloroacetic acid. Because of the hereditary component, they may or may not indicate high blood levels of cholesterol. Where there is no family history of xanthelasmata they usually indicate high cholesterol and may correlate with a risk of atheromatous disease (cholesterol building up in arteries). The root of the word is from Greek xanthos, "yellow".

They represent an accumulation of lipid-containing macrophages in the dermis. In about 50% of patients lipid levels are normal although in young individuals with this condition there is a higher incidence of hypercholesterolaemia . Possible causes are raised cholesterol , hyperlipidaemia states , diabetes mellitus and obesity. They cause no harm, but can increase in size producing cosmetic blotch.

Gross and microscopic appearance

It is of yellow flat plaques over the upper or lower eyelids. In other areas of the body the individual lesion is called xanthoma.

Xanthoma is a tumour composed of Lipid filled histiocytes containing lipid material in the cytoplasm. A prominent manifestation of the hyperlipoproteinaemias is xanthomas in soft tissue, tendinous, subperiosteal and intraosseous locations. Tuberous and tendinous xanthomas produce nodular masses in soft tissue (Sycosis) and tendons that rarely calcify ; tendinous xanthomas are common in the fingers, heel, elbow and knee, at which sites they may erode subjacent bone.

Subperiosteal xanthomas are associated with scalloping  of the external cortical surface. Intramedullary deposition of lipids  leads to lytic defects and pathologic fractures .

Ultrasonography, CT and MR imaging are favoured for the diagnosis of soft tissue xanthomas. The signal intensity of xanthomas on MR imaging varies. The tumours may be of persistent low to intermediate signal intensity on T1-weighted and T2-weighted spin-echo MR images and may show an inhomogeneous signal pattern. Focal areas of high signal intensity may occasionally be encountered on T2-weighted images, however. Some patients reveal a diffuse speckled pattern of signal intensity within a tendon.

Pathogenesis of Pathogenesis

 Xanthelasma may follow erythroderma  and inflammatory skin disorders  in the presence of normal lipid profiles.

The mechanism that initiates macrophage accumulation , cholesterol uptake  and foam-cell formation  in a normolipaemic patient following an inflammatory skin disorder (Psora) is not yet been elucidated a mechanism.This mechanism has been suggested is that increased plasma lipid peroxidation (Psora) (derived from oxidized low-density lipoprotein) may lead to accumulation of cholesterol (Sycosis) in macrophages and formation of foam cells (Sycosis).

Differential diagnosis and synonymous complaints

 

  •  Syringomas (Cancerous) are small papules on lower eyelids and are skin coloured.
  •  Large milial cysts (Psora/ Sycosis) are white and spherical. Xanthomas in other areasmay appear more orange-yellow.
  •  Gastric Xanthelasmas are macroscopically well demarcated yellow or yellow-white plaques, and microscopically composed of typical foamy macrophages. There is moderate predominance of males over females. The age ranges between 21 and 69 years. Gastric xanthelasmas are most frequently found in the antrum, especially along the lesser curvature. Associated chronic gastritis in the xanthelasma surrounding mucosa is common and intestinal metaplasia is also seen in some. The cause of gastric xanthelasma is unknown, but chronic gastritis may be the most probable etiologic factor. 

Homoeopathic Treatment for Xanthelasma :

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution, family history, presenting symptoms, underlying pathology, possible causative factors etc. .Although there are many medicines in Homeopathy with the help of which we can desolve the excessive fat/cholesterol in the body with help of homeopathy.

The homeopathic medicines are selected after a full individualizing case history, which includes the medical history of the patient, physical and mental constitution, family history, present complaints, past history, underlying pathology, possible causative factors, exciting factors, lifestyle, type of work, habits etc.

After studying complete history of the patient and repertorisation the medicine is to be found out which is called as constitutional remedy. It is important to give the homeopathic medicines which are constitutional or near to constitutional remedy (according to symptoms' similarity) to get positive results.

 

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About Dr. GS Makkar


Dr. GURPREET SINGH MAKKAR is a dynamic homeopath from India(pb). He is an ardent student of classical Homeopathy. He is a registered doctor degree holder (B.H.M.S.) from Sri Guru Nanak Dev Homoeopathic medical college(S.G.N.D Barewal Ludhiana,PUNJAB, India.
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