Treatment of diffuse plane xanthoma of the face with the Erbium:YAG laser.

A 23-year-old woman presented with an 8-year history of progressive diffuse plane xanthomata of the face and neck. Beginning at the earlobes and neck, these yellowish maculopapular lesions had spread over the whole face and neck region, making the patient look as if she were wearing a mask (Figure 1A and Figure 2A). Histologic features were typical for plane xanthoma with multiple foam cells surrounding the sebaceous glands and hair follicles in the whole dermis, in parts reaching the dermis-fat junction. Electron microscopic findings showed foamy histiocyte-like cells and solitary infiltrating giant cells in the dermis. Triglyceride, lipoprotein, and cholesterol levels were normal. Other reasons (eg, monoclonal gammopathies, lymphoproliferative diseases, or normolipemic xanthomatous syndromes) were excluded as well by findings from lipidand immunoelectrophoresis, blood cell counts, radiography of the skull, and electron microscopy, which were consistent with diffuse idiopathic plane xanthoma (group II, type 1).