Small Yellow Plaques on Eyelids Should Be Investigated

Xanthelasmata are flat yellowish plaques that appear on or near the eyelids.  They don’t usually give rise to immediate health problems, but they are unsightly and are likely to take the subject to the doctor, sooner or later.  The fact that they contain cholesteryl esters and are often linked to raised blood lipid levels led Danish scientists to study their relation to subsequent cardiovascular problems.  They also examined the prognostic relevance of a more frequent eye condition, arcus corneae (a.k.a. arcus senilis), a gray or white arc visible above and below the outer part of the cornea.  Their findings are reported in the British Medical Journal.

Xanthelasmata   

arcus senilis

Data came from the Copenhagen City Heart Study.  Nearly 13,000 Danish adults were followed for an average of 22 years. At baseline, 4.4% of the participants had xanthelasmata and 25% had arcus corneae.  Cardiovascular events during follow-up showed subjects with xanthelasmata were significantly more likely to experience a heart attack (1.48-times), coronary heart disease (1.36-times), severe atherosclerosis (1.69-times), and death (1.14-times) than those without xanthelsmalata.  It’s noteworthy that xanthelasmata were not associated with an increased risk of stroke.  There were also no significant associations between the presence of arcus corneae and cardiovascular events.  The highest absolute 10-year risks for heart attack, coronary artery disease, severe atherosclerosis, and death, in men aged 70-79 with and without xanthelasmata were 53% and 41%, respectively.  Corresponding values for women were 35% and 27%.

This study might not seem very valuable to physicians, who’ve been taught at medical school that xanthelasmata are linked with cholesterol levels.  But it does remind us of the need for people who see these plaques to contact their doctors, rather than their cosmeticians, to have a blood lipid panel done, and to accept treatment advice from their doctor (lifestyle changes and maybe drugs), if necessary.