Last Updated on November 10, 2023 by Beth Skwarecki
Eruptive xanthomatosis (EX) is a rare skin condition directly linked to hypertension or high blood pressure of more than 140/90 mmHg or higher. Specifically, this skin rash occurs when one has too much cholesterol or fat in their blood.
One of the common symptoms of EX is xanthomas. They’re small (around one four 4 millimeters), raised, wax-appearing bumps. They can be skin-toned, brown, yellow, pink, red, or a mixture of colors. They look like rashes (like measles or chickenpox), lesions, or plaques but are painless and harmless.
Because xanthomas are clumps of cholesterol, treating them also involves removing the extra fat in the body. This, in turn, can help prevent high cholesterol and other related serious illnesses.
Causes Eruptive Xanthomatosis (EX)
The main cause for XE is having high levels of cholesterol in the blood, which various factors can influence. These may include inherited traits, health conditions, prescribed medications, and lifestyle choices. Let’s delve into them more.
#1. Genetic conditions
Elevated levels of cholesterol can be passed down through families. For example, familial hypercholesterolemia (FH) is a common genetic condition that may cause children to get xanthomas.
Xanthomas in children can be treated. If you want this covered by insurance, shop medicare plans that cover dermatology and prevention. Above all, bring them to a pediatrician as soon as possible. Although xanthomas are harmless, they may suggest an underlying undiagnosed condition, potentially linked to a higher risk of heart problems.
Another hereditary condition that results in high cholesterol levels is cerebrotendinous xanthomatosis, which is a rare metabolic disorder. This disorder hinders the breakdown of cholesterol, increasing the likelihood of developing XE.
Additionally, individuals who consume excessive amounts of plant sterols may have an increased risk of developing XE. They’re substances similar to cholesterol, but plants produce them. This rare hereditary metabolic disorder is known as familial sitosterolemia.
#2. Health Conditions
Some illnesses can result in elevated fat and cholesterol levels in the bloodstream, raising the chances of developing xanthomas. These health conditions comprise type 2 diabetes, chronic kidney disease, hypothyroidism (an underactive thyroid), pancreatitis (inflammation and swelling of the pancreas), liver disorders, lupus, HIV/AIDS, and certain types of cancer.
#3. Drugs and Treatments
Antidepressants (such as Sertraline), oral retinoids, steroids (such as estrogen and estrogen replacement), and protease inhibitors (a treatment for HIV) may lead to fat accumulation in the body. The greater the intake of these medications, the higher the likelihood of cholesterol and fats building up in the bloodstream. This can make a person more prone to developing xanthomas.
In addition to elevated cholesterol levels, tattooing can also be a potential cause of xanthomas. Evidence suggests it may trigger a Koebner phenomenon, where new xanthomas form on healthy skin (typically in lesions rather than bumps).
Unhealthy habits can increase cholesterol levels and, eventually, the risk of xanthomas. Such harmful lifestyle factors include being sedentary, overweight or obese, consuming foods high in saturated fats excessively, drinking alcohol regularly, and smoking cigarettes.
Treatments for Eruptive Xanthomatosis (EX)
Xanthomas may disappear naturally and typically don’t result in lasting scars. Still, as previously mentioned, it’s essential to seek medical advice to help identify and prevent underlying conditions that cause them to occur on the skin.
There are instances when xanthomas don’t cause noticeable symptoms, but some individuals may experience itching, tenderness, pain, or oozing. In such cases, it’s advisable to consider xanthomas removal.
There are various methods for xanthoma removal, including:
- Topical treatment: This typically involves using a chemical peeling agent, such as trichloroacetic acid.
- Cryosurgery: This technique uses either liquid nitrogen or argon gas to freeze and instantly destroy abnormal cells.
- Laser surgery: This method employs a precisely calibrated laser to eliminate the xanthoma.
- Surgical excision: This involves cutting out the affected tissue.
Even after undergoing removal, xanthomas may return. It’s crucial to remember that high cholesterol levels primarily cause them. Unless these levels are brought down and any underlying medical issues are addressed, xanthomas may continue to appear on the skin.
For example, if you’re diabetic, taking insulin as needed and managing your blood sugar levels can help reduce your cholesterol levels and lower the risk of xanthomas. Seeking medical guidance for this is important.
Cholesterol-lowering medications can also be effective in treating xanthomas. Some of these medications include:
- HMG-CoA reductase inhibitors: These can assist in lowering cholesterol levels.
- Ezetimibe: This medication can help reduce the amount of cholesterol absorbed from the gut.
- Fibrates: They work to decrease the production of triglycerides in the liver.
- Niacin: This can be beneficial in lowering levels of bad cholesterol and triglycerides.
- Bile acid resins: These medications can help lower levels of harmful cholesterols.
Another consideration for treatment is that xanthomas often develop in areas of the body where wounds heal slowly, such as the back of the arms, thighs, buttocks, and legs. They may also appear around the eyes, scalp, face, neck, back, stomach, and knees. It’s important to take extra precautions if they occur in areas that may be irritated through direct or indirect contact with the external environment.
Xanthomas are harmless and treatable. Before taking any medications, it’s essential to consult with a doctor to understand their benefits, potential side effects, and any associated risks, as well as diagnose and treat the underlying health conditions that cause them to appear.
Beth is Cloudmineinc’s senior health editor and a certified personal trainer. She has over 10 years experience as a science journalist and is the author of two books. She deadlifts over 315 lbs.