Xanthomas of the Achilles Tendon

Xanthomas are skin lesions caused by fat accumulation of fat in the microphage immune cells in the skin.

They are indicative of lipid metabolism disorders, like high cholesterol levels, high blood fats, coronary artery heart disease, pancreatitis, and hyperlipidaemia.
There are several different types of xanthomas that can appear on the body, and one of the most common areas is on the Achilles tendon.
On the Achilles tendon they will appear slowly, and emerge as nodules on the tendon or ligament. This particular type of xanthoma is associated with severe hypercholesterolaemia and elevated LDL levels.
Most doctors will order blood and urine tests and X-rays to determine the cause of the elevated LDL levels and high cholesterol. It is crucial to determine the cause of the condition to lower the risk for further complications, which can include heart attacks, stroke, and peripheral vascular disease.
Treatment for xanthomas includes identifying and treating the underlying lipid disorder. In many cases, treating the disorder will reduce and sometimes eliminate the xanthoma. Dietary measures will be recommended, and may include:

• Preparing meals from vegeatables, fish, and cereals.
• Minimize intake of saturated fats (meats, dairy products, oils).
• Minimize intake of simple, refined sugars (sodas, sweets).
• Lose weight if overweight or obese.

Medications prescribed may include:

• Statins, like simvastatin and atorvastatin, which reduce cholesterol production in the liver.
• Fibrates, like bezafibrate, which can reduce the triglyceride production by the liver and increase HDL (good cholesterol).
• Ezetimibe, which is given to the most severe patients. This medication will reduce cholesterol absorption in the stomach.
• Nictinic acids lower cholesterol, LDL cholesterol, and increase HDL cholesterol.

Surgery may be recommended when the xanthomas do not resolve with appropriate treatment.

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