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INTRODUCTION
Cutaneous xanthomas develop as a result of deposition of lipid in the dermis, primarily within macrophages (foam cells) but also extracellularly. One of their major distinguishing clinical features is a characteristic yellow to orange hue. Xanthomas may present with a variety of morphologies, from macules and papules to plaques and nodules. As discussed below, the morphology and anatomic location of the lesions often suggest the type of underlying lipid disorder or the presence of a paraproteinemia.
Xanthomas can develop in the setting of primary or secondary disorders of lipid metabolism. Thus, early recognition of these lesions can make a significant impact on the diagnosis, management, and prognosis of patients who suffer from an underlying disease. It is therefore important for dermatologists to become familiar with the basic concepts of lipid metabolism and the associated disease states, as well as to be able to recognize the often pathognomonic cutaneous findings.