Part 69

The tumors are seated in the corium, extending into the deeper structure, and consist of nerve-fibres, yellow elastic tissue, blood vessels and lymphoid cells.

In the two cases reported, excision of the nerve-trunk gave, in one instance, permanent relief; in the other the effect was only temporary.

#Xanthoma.# (Synonyms: Vitiligoidea; Xanthelasma.)

#What is xanthoma?#

Xanthoma is a connective-tissue new growth characterized by the formation of yellowish, circumscribed, irregularly-shaped, variously-sized, non-indurated, flat or raised patches or tubercles.

#Name the two varieties met with.#

The macular or flat (xanthoma planum) and the tubercular (xanthoma tuberculatum or tuberosum). In some instances both varieties (xanthoma multiplex) are seen in the same individual.

#Describe the clinical appearances of xanthoma planum.#

The macular or flat variety is usually seen about the eyelids. It consists of one, several or more small or large, smooth, opaque, sharply-defined, often slightly raised, yellowish patches, looking not unlike pieces of chamois-skin implanted in the skin.

#Describe the clinical appearances of xanthoma tuberosum.#

The tubercular variety is commonly met with upon the neck, trunk and extremities. It occurs as small, raised, isolated, yellowish nodules, or as patches made up of aggregations of millet-seed-sized or larger tubercles. The lesions may be few or they may exist in great numbers.

#What is the course of xanthoma?#

Extremely slow; after reaching a certain development the growths may remain stationary.

#State the etiology of xanthoma.#

The causes are obscure. Jaundice not infrequently precedes and accompanies its development, especially in the tubercular variety. The disease is uncommon, and is usually seen in middle and advanced life, and more frequently in women. In some cases (xanthoma diabeticorum) of general xanthoma diabetes is the causative factor.

#What is the pathology of xanthoma?#

It is a benign, connective-tissue new growth, with concomitant or subsequent, but usually partial, fatty degeneration.

#Give the prognosis of xanthoma.#

The condition is persistent, and usually irresponsive to all treatment save destructive or operative measures.

#What is the treatment of xanthoma?#

Treatment consists, in suitable cases, of excision; in some instances, electrolysis is serviceable. Applications of trichloracetic acid cautiously made are sometimes of value. In that form of general xanthoma due to diabetes the treatment of this latter condition will materially and sometimes completely remove the eruption.

#Myoma.# (Synonyms: Myoma Cutis; Dermatomyoma; Liomyoma Cutis.)

#Describe myoma.#

The disease is rare, and consists usually of one or several (exceptionally numerous), variously-sized tumors of the skin, made up of smooth muscular fibres. They are flat, rounded, oval or pedunculated, and have a smooth surface and a pale-red color; as a rule, they are painless.

The growth is benign, and consists essentially of a new formation of unstriped muscular fibres; but it may also be composed largely of connective tissue (fibromyoma); or it may contain an abundance of bloodvessels (myoma telangiectodes, angiomyoma); or there may be lymphatic involvement (lymphangiomyoma).

#Angioma.# (Synonyms: Nævus Vasculosus; Nævus Sanguineus.)

#Give a definition of angioma.#

Angioma is a congenital hypertrophy of the vascular tissues of the corium and subcutaneous tissue. Exceptionally it makes its appearance a few weeks or a month after birth.