Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Case Letter
ARTICLE IN PRESS
doi:
10.25259/IJDVL_339_2023

Successful treatment of xanthelasma palpebrarum grade III with copper vapour laser radiation (578 nm)

LPI Troitsk science park, P.N. Lebedev Physical Institute, Moscow, Russian Federation
Department of Social Paediatrics, National Medical Research Centre of Children’s Health, Moscow, Russian Federation

Corresponding author: Dr. Igor V. Ponomarev, LPI Troitsk science park, P.N. Lebedev Physical Institute, Moscow, Russian Federation. luklalukla@ya.ru

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Ponomarev IV, Topchiy SB, Shakina LD. Successful treatment of xanthelasma palpebrarum grade III with copper vapour laser radiation (578 nm). Indian J Dermatol Venereol Leprol doi: 10.25259/IJDVL_339_2023

Dear Editor,

Xanthelasma palpebrarum appears as yellowish plaques on eyelids. The prevalence of xanthelasma palpebrarum varies from 0.3% in men to 1.1% in women. 1 Xanthelasma is reported to have a tendency to enlarge and may cause aesthetic problems, eyelid dysfunction and evident cosmetic problems. Xanthelasma palpebrarum never resolves spontaneously. The severity of xanthelasma palpebrarum corresponds to grade I if the lesions are present only on the upper eyelids, grade II if the lesions extend to the medial canthal area, grade III if the lesions are present on medial side of both upper and lower eyelids and grade IV if there is diffuse involvement on medial and lateral aspects of upper and lower eyelids. 2 Surgical management for xanthelasma palpebrarum when required, besides excision and blepharoplasty, has to include additional skin or the orbicularis muscle flap. In a diffusely involved area, more intensive chemical, cryothermal, ablative lasers (CO2, Er:YAG) or cautery interventions are needed to eliminate xanthelasma completely, but they were recommended only for the early stages of xanthelasma palpebrarum. Because of the small thickness of the eyelid dermis, it is very important to select an appropriate method of treatment for xanthelasma, as cautery or excision of xanthelasma palpebrarum can cause recurrence and scar formation. 3

Laser radiation at 578 nm proves to be the most appropriate for the treatment of xanthelasma palpebrarum. 4 Pathogenetic treatment of the xanthelasma palpebrarum must prevent the transfer of low-density lipoproteins (LDL) via the permeable vascular wall and blocking the blood flow in microvessels, phagocytosis of LDL-overloaded foam cells and remodelling the vascular bed in the recovered upper dermis. 4

The copper vapour laser radiation at a wavelength of 578 nm implements photothermal blockage of the blood flow in highly permeable microvessels inside the involved upper dermis around xanthelasma palpebrarum. 5 The effective laser radiation penetration depth does not exceed the thickness of the eyelid dermis due to the high absorption of radiation by oxyhaemoglobin and haemoglobin.

A 72-year-old lady presented with yellowish plaques on the medial aspects of both upper and lower eyelids of more than 12 years duration [Figure 1a]. A clinical diagnosis of xanthelasma palpebrarum grade III was made.

A 72-year-old lady with bilateral grade III xanthelasma palpebrarum
Figure 1a:
A 72-year-old lady with bilateral grade III xanthelasma palpebrarum

The lesions were successfully treated with a copper vapour laser (Yakhroma-Med, P.N. Lebedev Physical Institute of RAS) at a 578 nm wavelength, an average power of 0.8 W, an exposure time of 0.2 s and a 1 mm light spot diameter.

The laser management of xanthelasma palpebrarum was performed with stainless steel corneal eye shield after a topical ophthalmic local anaesthetic application for 20 minutes.

The lesion was treated with laser pulses using a multiple stacking pass technique until the entire treated area acquired a greyish tint. The removal of xanthelasma palpebrarum was carried out during a single session.

After the procedure, the irradiated skin was treated with a 0.05% chlorhexidine gluconate solution, followed by the application of an epithelizing cream with bepanthene twice a day. The patient was advised to avoid sun exposure and use topical sun protection cream with a sun protection factor of at least 30.

The irradiated skin healed with crusting and exfoliation over two weeks. During a 24-month follow-up period, no side effects or recurrence occurred.

The copper vapour laser is minimally invasive, safe and effective treatment of xanthelasma palpebrarum with a good cosmetic outcome [Figure 1b]. It can be a good alternative approach to the surgical excision or the ablative laser mode. More studies are required to determine the optimal settings for the copper vapour laser treatment of eyelid lesions in patients with different skin phototypes.

Clearance of bilateral grade III xanthelasma palpebrarum, two months after the copper vapour laser treatment
Figure 1b:
Clearance of bilateral grade III xanthelasma palpebrarum, two months after the copper vapour laser treatment

Acknowledgement

Authors are grateful to Dr Marina Solovieva, Medical Center MisMed, Nizhny Novgorod, Russian Federation for clinical supporting this study.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. , , . Significance of xanthelasma palpebrarum in the normal population. Lancet. 1976;76:372.
    [Google Scholar]
  2. , , , , . Outcomes of surgical management of xanthelasma palpebrarum. Arch Plast Surg. 2013;40:380-6.
    [CrossRef] [PubMed] [Google Scholar]
  3. , , , , , , et al. A comprehensive examination of topographic thickness of skin in the human face. Aesthet Surg J. 2015;35:1007-13.
    [CrossRef] [PubMed] [Google Scholar]
  4. , , . Xanthelasma: An update on treatment modalities. J Cutan Aesthet Surg. 2018;11:1-6.
    [CrossRef] [PubMed] [PubMed Central] [Google Scholar]
  5. , , , . Thermal sensitivity and haemolysis of erythrocytes with membranopathy. J Therm Biol. 2019;81:98-102.
    [CrossRef] [PubMed] [Google Scholar]

Fulltext Views
2,057

PDF downloads
1,095
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections