Diffuse Normolipemic Plane Xanthoma (DNPX) of the Neck without Xanthelasma Palpebrum

Abstract

Diffuse normolipemic plane xanthoma (DNPX) is an uncommon subtype of non-Langerhans histiocytosis. DNPX is characterised by xanthelasma palpebrarum, diffuse plane xanthoma of the head, neck, trunk, or extremities, and normal plasma lipid levels. The neck is the most common site. We report about a 62-year-old female Caucasian patient, who developed an asymptomatic fine wrinkling and loose skin on the neck and décolleté about three years ago. The skin colour became yellowish. Xanthelasma was absent. Histopathology of a skin biopsy confirmed the diagnosis of DNPX. The patient had a medical history of chronic myeloblastic leukaemia. No other laboratory abnormalities were found. Laser treatment was offered but opposed by the patient.

Role of carbon dioxide laser in treatment of xanthelasma palpebrarum

“…Regarding the site of xanthelasma lesions, this research found that majority of the cases had lesions on the upper eye lids and may extend to medial canthus. Govorkova et al [14] and Zak et al [15] reported predominance of xanthelasma lesions in upper eyelids which is in agreement with our research. The reason why these lesions develop only in the eyelids and not in other sites of the body still remains obscure [16] .…”

“…Khode et al, [17] found that 52% of their xanthelasma cases showed abnormal lipid profile, and they concluded that xanthelasma plaque formation may be due to increasing heat, physical action, and friction all contributed to the release of lipids from blood vessels into the surrounding tissue. Multiple studies have suggested that reduced cholesterol clearance from tissues due to low HDL levels contributes to the development of xanthelasma lesions in normolipidemic cases [15,18] . This finding agreed with previous studies done by Tursen et al [12] , Ribera et al [13] , and Wang et al [19] which reported that the percentage of cases present with XP and have normal lipid profile, ranges from 20%to 70% and they seek therapy for cosmetic reasons.…”