skip to main content

Xanthelasma — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardInflammatory DermatosesXanthelasmaSCE Dermatology

A 52-year-old has clinically typical bilateral xanthelasma but has never had metabolic assessment. There are no visual symptoms and she asks for immediate laser treatment. What should the consultation include before lesion-directed treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Check a lipid profile and cardiovascular risk; explain treatment recurrence

Explanation lettering: E = shown as A · C = shown as B · D = shown as C · B = shown as D · A = shown as E

E is correct. Xanthelasma is usually a clinical diagnosis and may occur despite a normal lipid profile, but its presence should prompt lipid and broader cardiovascular-risk assessment. Management of any dyslipidaemia is driven by cardiovascular risk rather than a promise that plaques will regress. Lesion-directed options are elective and recurrence is common, so expectations and risks near the eyelid should be discussed. Symmetry does not establish normal lipids, routine bilateral biopsy is unnecessary in a typical presentation, statins do not reliably erase existing plaques, and exhaustive genetic investigation is not required in every patient. Atypical morphology would change the diagnostic approach.

Reference: DermNet xanthoma and xanthelasma review: https://dermnetnz.org/topics/xanthoma