The following is the histology of a lesion removed from a 58 year-old man's eyelid.

• What is the diagnosis and why?


Answer
Xanthelasma. Presence of multiple foam cells in the 
dermis. The foam cells are made up of histiocytes 
that have phagocytosed cholesterol.


 
• What systemic abnormality may be associated with this condition?
a
Answer
Hyperlipoproteinaemia especially type II and III.
This is seen in 1/3 of the patients with xanthelasma.