[Diffuse normolipemic xanthoma planum].

Abstract

We comment on the case of a 75-year-old woman whose dermatologic process had started 15 years before with the onset of xanthelasma on the lower eyelids which were surgically removed, recurring on the scar areas two months later. At the same time new lesions involved the forehead as well as the periorbital and malar regions. Some months later new yellow papular lesions appeared involving the neck, thorax, pelvis and extremities which grew eccentrically covering large areas. Five years later the lesions localized on the face and showed a progressive tendency to atrophy in their centers while those localized on the trunk showed an evolution to sclerosis of their central area. There was no mucosal involvement or ulceration in any of the xanthomatous lesions. The microscopic study revealed the existence of a dermal infiltrate formed by histiocyte foamy frothy cells and Touton cells, among which there were some lymphocytes, which occasionally adopted a perianexial, perineural and perivascular pattern but there were no signs of thrombosis or degenerative changes in the perilesional connective tissue. The study by chromatography of the lipid composition of the pathologic skin revealed an increase in cholesterol esters. The laboratory exams as well as the general physical examination performed every six months for a period of 15 years' time were always normal except for a moderate elevation of ESR which persisted throughout the process.(ABSTRACT TRUNCATED AT 250 WORDS)