Lugo-Somolinos Aída, Sánchez Jorge E
Department of Dermatology, University of Puerto Rico, School of Medicine, PO Box 365067, San Juan, Puerto Rico 00936-5067.
Bol Asoc Med P R. 2003 Jul-Aug;95(4):12-6.
Xanthomas are deposits of lipids in the skin and sometimes of the subcutaneous tissue that are expressed clinically as yellowish papules and plaques, nodules, and tumors. They are often, but not always, a consequence of hyperlipidemia. In these cases, a meticulous work-up nearly always reveals some disturbance in regards to the metabolism of the lipids-lack of certain lipoproteins, for example. Xanthoma tuberosum and tendinosum occur in persons with familiar hypercholesterolemia, palmar crease xanthoma in familial dysbetalipoproteinemia, plane xanthoma in persons with an underlying lymphoproliferative disorder (or normolipemic), and eruptive xanthoma in those with a genetically-transmitted lipoprotenemia. In sum, each type of xanthoma and any associated abnormality in lipid metabolism can be diagnosed with specificity. Xanthomas are deposits of lipid in the skin or subcutaneous tissue that manifest clinically as yellowish papules, nodules and tumors. They are often associated with hyperlipidemias, although some of them may be normolipemic. Xanthomas result when abnormalities in the transportation of lipids such as cholesterol, triglycerides and phospholipids cause these lipids to be deposited in the skin and being ingested by tissue macrophages. When they are deposited in the walls of arteries, they promote the development of atherosclerosis. Sometimes, by identifying the clinical variant of the xanthoma, the lipoprotein that is deposited and the clinical associations can be predicted. This discussion will focus on those xanthomas associated with hyperlipidemias.
黄瘤是皮肤以及有时皮下组织中的脂质沉积，在临床上表现为淡黄色丘疹、斑块、结节和肿瘤。它们常常（但并非总是）是高脂血症的结果。在这些情况下，细致的检查几乎总能发现脂质代谢方面的某些紊乱——例如缺乏某些脂蛋白。结节性和腱性黄瘤见于家族性高胆固醇血症患者，掌纹黄瘤见于家族性异常β脂蛋白血症患者，扁平黄瘤见于患有潜在淋巴增殖性疾病的患者（或血脂正常者），发疹性黄瘤见于患有遗传性脂蛋白血症的患者。总之，每种类型的黄瘤以及脂质代谢中的任何相关异常都可以特异性地诊断出来。黄瘤是皮肤或皮下组织中的脂质沉积，临床上表现为淡黄色丘疹、结节和肿瘤。它们常与高脂血症相关，尽管其中一些可能血脂正常。当胆固醇、甘油三酯和磷脂等脂质运输出现异常，导致这些脂质沉积在皮肤并被组织巨噬细胞摄取时，就会形成黄瘤。当它们沉积在动脉壁时，会促进动脉粥样硬化的发展。有时，通过识别黄瘤的临床变体，可以预测沉积的脂蛋白及其临床关联。本讨论将聚焦于与高脂血症相关的那些黄瘤。
