The store-and-forward feature of teledermatology allows patient medical information (including history and visual data) obtained from one provider's location to be electronically transferred to a provider in another location (Roman & Jacob, 2014). The construct of the TeleDermViewPoint column is such that cases are presented in a standardized teledermatology reader format reflective of an actual teledermatology report.
HISTORY
Chief complaint: presenting for diagnosis.
TELEDERMATOLOGY READER REPORT1
History
Chief complaint: presenting for diagnosis of lesions.
History of present illness: A 67-year-old white man presents for an evaluation of lesions on his left eyelid. Primary symptom: asymptomatic. Prior biopsy: none.
Image Quality Assessment
Fully satisfactory.
TELEDERMATOLOGY IMAGING READER REPORT1
One image was provided with this consult, which shows a solitary yellow-orange smooth plaque on the left upper eyelid (Figure 1).
INTERPRETATION OF IMAGES
Findings suggest xanthelasma.
RECOMMENDATIONS
Reassurance.
Because more than 50% of persons with xanthelasmas have a lipid metabolism disorder, it is recommended that baseline plasma lipid levels are obtained, including high-density lipoprotein and low-density lipoprotein cholesterol levels, triglyceride level, and apolipoprotein B100 level (Ozdol et al., 2008). If diagnostic lipid tests show abnormal results, recommending appropriate dietary restriction and pharmacologic reduction of serum lipids is warranted.
CLINICAL PEARL
Xanthelasma presents as yellow-to-orange papules or plaques, which usually form in the fourth or fifth decade of life and are asymptomatic. "Xanthelasma palpebrarum" is the term for xanthelasma that appears on or near the eyelids (Ozdol et al., 2008). These papules and plaques form from increased deposition of lipids that lead to aggregation of lipoproteins. These lipoprotein aggregates are then taken up by macrophages that coalesce together to form xanthelasmas. Xanthelasma has been shown to be an independent risk factor for atherosclerosis (Bergman, 1994).
It is important to note that these are benign lesions and treatment of the lesion would be mainly for cosmetic reasons. Several treatment options are available for the removal, including surgical excision, argon and carbon dioxide laser ablation, chemical cauterization, electrodesiccation, and cryotherapy (Dahl, 2020).
REFERENCES