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Papular xanthoma

Papular Xanthoma (PX) — Comprehensive Disease Characteristics Report

2026-05-07
Falcon MONDO:0015536 Model: Edison Scientific Literature 20 citations

Papular Xanthoma (PX) — Comprehensive Disease Characteristics Report

Target disease

  • Disease name: Papular xanthoma (PX)
  • Category: Rare dermatologic disorder; cutaneous non‑Langerhans cell histiocytosis (xanthomatous)
  • MONDO / Orphanet / OMIM / MeSH / ICD identifiers: Not available in the retrieved full-text sources used for this report; should be obtained from MONDO/Orphanet/ICD/MeSH databases in a separate curation step.

Evidence base and recency note

Papular xanthoma is very rare and much of the literature consists of case reports/series. The most directly informative recent source retrieved here is a 2023 case report with literature review (Journal of Cutaneous Pathology, May 2023). Several key clinicopathologic facts come from a foundational 10‑case series (2002) and pediatric case reports (2010–2020). (francois2023multiplepapularxanthomas pages 2-2, breier2002papularxanthomaa pages 1-2, ramessur2020eruptivepapulesin pages 1-2)

PMID note: PMIDs were not present in the retrieved text extracts; therefore this report cites DOI/URLs and the tool-provided context IDs.

1. Disease information

1.1 Overview (what is the disease?)

Papular xanthoma (PX) is a rare, primarily cutaneous, xanthomatous lesion characterized by a dermal proliferation/infiltrate of lipid-laden (“foamy”) histiocytes/macrophages, typically occurring with normal serum lipid profiles (normolipemic) and classified among cutaneous non‑Langerhans cell histiocytoses. (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2, breier2002papularxanthomaa pages 1-2)

1.2 Synonyms / alternative names

1.3 Evidence source type

The current understanding is derived predominantly from aggregated disease-level literature (case series and reviews) plus individual patient case reports, rather than EHR-scale evidence. (breier2002papularxanthomaa pages 2-4, francois2023multiplepapularxanthomas pages 2-2, ramessur2020eruptivepapulesin pages 1-2)

1.4 Key recent and authoritative sources (publication date; URL)

2. Etiology

2.1 Disease causal factors

No single genetic cause or infectious agent was identified in the retrieved literature excerpts. PX is framed as a clinicopathologic entity within non‑Langerhans cell histiocytoses, defined by a macrophage/foam-cell infiltrate pattern rather than a known monogenic defect. (breier2002papularxanthomaa pages 2-4, breier2002papularxanthomaa pages 1-2)

2.2 Risk factors

  • Age: PX occurs in both children and adults; adult disease may show a biphasic pattern (adolescence and middle age) in the 10-case series. (breier2002papularxanthomaa pages 1-2)
  • Lipid dysregulation (possible, not required): Although PX is classically normolipemic, exceptions exist. Pediatric cases with abnormal lipid profiles have been reported and authors argue lipid criteria may need reevaluation. (arbuckle2010casereport—papularxanthoma pages 1-3, ramessur2020eruptivepapulesin pages 1-2)

2.3 Protective factors

No protective genetic or environmental factors were identified in the retrieved sources.

2.4 Gene–environment interactions

No gene–environment interaction evidence was identified in the retrieved sources.

3. Phenotypes

3.1 Cutaneous phenotypes (symptoms/signs)

Core phenotype: Asymptomatic yellow/yellow‑brown papules (sometimes papulonodules), often widespread; may be solitary or disseminated. (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2)

Distribution: - Adult series: trunk and extremities predominated; head less common; most were solitary lesions (9/10). (breier2002papularxanthomaa pages 1-2) - Pediatric PX: often head, trunk, extremities with sparing of mucosa, palms, soles, and generally flexures (except axillae), though presentations vary. (ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2)

Periorbital/eyelid involvement: PX can present with yellowish papulonodular lesions “often located around the eyes” in periorbital lesion reviews; eyelid involvement is illustrated in an eyelid-focused review of xanthomatous lesions. (rebora2011periorbitallesions. pages 4-5, baykal2017theclinicalspectrum pages 1-2)

3.2 Laboratory abnormalities

  • Classically normal lipid profile is part of diagnostic criteria, but not universal. (ramessur2020eruptivepapulesin pages 1-2, arbuckle2010casereport—papularxanthoma pages 1-3)
  • Example pediatric workup with normal lipids and other labs: CBC, LFTs, TFTs, immunoglobulins, serum protein electrophoresis (SPEP), and imaging (liver/spleen ultrasound) all normal in one case. (ramessur2020eruptivepapulesin pages 1-2)

3.3 Phenotype characteristics (onset/severity/progression/frequency)

3.4 Quality of life impact

Formal QoL instruments (e.g., DLQI, PROMIS) were not reported in the retrieved sources. The main impacts described are cosmetic burden and potential residual atrophic/hyperpigmented scarring after lesion regression in children. (ramessur2020eruptivepapulesin pages 1-2)

3.5 Suggested HPO terms (phenotype encoding)

(These are suggested mappings based on described clinical findings; ontology IDs should be verified during curation.) - Yellow papules / xanthomatous papules → Xanthoma; Skin papule (ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2) - Periorbital distribution → Periorbital skin lesion (rebora2011periorbitallesions. pages 4-5) - Post-inflammatory hyperpigmentation / residual hyperpigmented macules → Hyperpigmentation of the skin (ramessur2020eruptivepapulesin pages 1-2) - Atrophic/anethoderma-like scarring → Atrophic scar / Anetoderma (ramessur2020eruptivepapulesin pages 1-2)

4. Genetic/Molecular information

4.1 Causal genes

No causal genes or recurrent pathogenic variants were identified in the retrieved PX evidence.

4.2 Molecular/cellular identity (immunophenotype)

PX lesions show a macrophage/histiocyte immunophenotype: - CD68 positive histiocytes are typical. (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2) - S100 negative and CD1a negative are repeatedly reported, supporting non‑Langerhans lineage. (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2) - Factor XIIIa (FXIIIa): variable across reports—positive in at least one pediatric case report and negative in the 10-case adult series and in an infant case review; this variability is important for differential diagnosis with juvenile xanthogranuloma and related entities. (ramessur2020eruptivepapulesin pages 1-2, breier2002papularxanthomaa pages 1-2, francois2023multiplepapularxanthomas pages 2-2)

4.3 Suggested GO/CL terms (mechanistic annotation)

(Conceptual mapping consistent with lesion composition; requires ontology verification.) - CL: macrophage / histiocyte (dominant foamy cells) (breier2002papularxanthomaa pages 2-4, breier2002papularxanthomaa pages 1-2) - GO Biological Process: lipid metabolic process / foam cell differentiation (inferred from “xanthomatized/foamy” macrophages; mechanistic detail not experimentally established for PX in these sources) (breier2002papularxanthomaa pages 2-4)

5. Environmental information

No specific toxins, occupational exposures, lifestyle factors, or infectious triggers were established as causal. Some case-based associations have been reported with inflammatory/eruptive contexts (viral/drug eruptions) but without mechanistic proof. (ramessur2020eruptivepapulesin pages 1-2)

6. Mechanism / Pathophysiology

6.1 Current understanding

PX is best understood as a localized cutaneous accumulation/proliferation of lipid-laden macrophages in the dermis, producing yellow papules/nodules. Histologically it is typically well delimited with dense infiltrates of xanthomatized cells and variable Touton giant cells, and with relative absence of inflammatory cells and lack of an early “primitive histiocytic” phase in classic descriptions. (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2)

6.2 Relationship to juvenile xanthogranuloma (JXG)

PX is repeatedly emphasized as a key histopathologic/clinical mimic of JXG; some authors consider PX within a spectrum/variant of xanthogranuloma (xanthomatous pattern). (francois2023multiplepapularxanthomas pages 2-2, ramessur2020eruptivepapulesin pages 1-2)

6.3 Evidence gaps

No pathway-level (e.g., MAPK, PI3K-AKT) or omics profiling findings (transcriptomics/proteomics) were identified in the retrieved PX sources.

7. Anatomical structures affected

7.1 Organ and tissue level

7.2 Cell types (Cell Ontology suggestions)

7.3 Subcellular/localization (GO CC suggestions)

Not directly studied in retrieved sources; lipid-laden/foamy cytoplasm implies lipid droplets/lysosomal compartments, but this remains inferential here.

7.4 UBERON suggestions

  • Skin of trunk/limb regions; periorbital skin/eyelid skin (verify exact UBERON terms during curation). (breier2002papularxanthomaa pages 1-2, rebora2011periorbitallesions. pages 4-5)

8. Temporal development

8.1 Onset

8.2 Progression/course

9. Inheritance and population

9.1 Epidemiology

No population prevalence/incidence estimates were found in retrieved sources.

Case-count statistics from reviews/series: - 2002 clinicopathologic series noted: “Until now, 43 cases of cutaneous PX have been described” (at that time). (breier2002papularxanthomaa pages 2-4) - 2023 literature review summary cited ~53–54 patients reported across ~22 reports, and that 18 had follow-up (median 28 months; mean 41.3 months) with 2 recurrent/persistent lesions. (francois2023multiplepapularxanthomas pages 2-2, francois2023multiplepapularxanthomas pages 2-3)

9.2 Inheritance

No inheritance pattern is established in the retrieved literature. A family history of hypercholesterolemia was noted in one pediatric PX case, but causality/inheritance specific to PX was not established. (ramessur2020eruptivepapulesin pages 1-2)

10. Diagnostics

10.1 Clinical criteria

Winkelmann’s PX diagnostic criteria (as reproduced in a pediatric diagnostic case discussion) include: 1) generalized asymptomatic yellowish papulonodular lesions without coalescing plaques, 2) normal lipid profile, 3) no visceral involvement, 4) foamy-cell predominant infiltrate, 5) absence of primitive histiocytic phase and inflammatory cells. (ramessur2020eruptivepapulesin pages 1-2)

10.2 Histopathology

Typical biopsy features include a well-delimited dermal tumor/infiltrate with a small grenz zone and dense infiltrate of foamy/xanthomatized histiocytes with numerous Touton-type giant cells (though Touton cells may be absent in some pediatric lesions). (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2)

10.3 Immunohistochemistry

Common IHC profile: - CD68+ histiocytes (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2) - S100−, CD1a− (helps exclude Langerhans cell histiocytosis) (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2) - FXIIIa: may be positive or negative depending on case/series; therefore should not be used as a sole discriminator. (ramessur2020eruptivepapulesin pages 1-2, breier2002papularxanthomaa pages 1-2, francois2023multiplepapularxanthomas pages 2-2)

10.4 Recommended workup (real-world practice)

From case reports and eyelid review guidance, commonly implemented evaluation includes: - Fasting lipid profile (including repeat testing if abnormal) (arbuckle2010casereport—papularxanthoma pages 1-3, ramessur2020eruptivepapulesin pages 1-2) - Screening for systemic disease/visceral involvement (e.g., ultrasound imaging in pediatric cases; chest X-ray in one report) (ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2) - Additional labs sometimes used: serum protein electrophoresis (SPEP) (arbuckle2010casereport—papularxanthoma pages 1-3) - Biopsy with histopathologic confirmation and IHC (ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2) - For xanthomatous eyelid lesions broadly: obtain history, exclude xanthelasma palpebrarum, detailed derm/systemic exam, biopsy, and “appropriate specific imaging screens.” (baykal2017theclinicalspectrum pages 1-2)

10.5 Differential diagnosis (key discriminators)

11. Outcome / Prognosis

11.1 Overall prognosis

11.2 Complications

12. Treatment

12.1 Current management (real-world implementation)

12.2 Reported therapies

  • One pediatric report notes an adult case report of PX “resolved satisfactorily with doxycycline” (secondary mention; primary adult doxycycline paper not retrieved here). (choudhary2015papularxanthomain pages 1-2)

12.3 MAXO (treatment ontology) suggestions

(Require MAXO ID verification during curation.) - Watchful waiting / observation (pediatric) (choudhary2015papularxanthomain pages 1-2) - Skin biopsy (diagnostic procedure; also a medical action) (ramessur2020eruptivepapulesin pages 1-2) - Systemic antibiotic therapy (doxycycline) — only case-level mention (choudhary2015papularxanthomain pages 1-2)

13. Prevention

No primary prevention strategies are established. Practical prevention is limited to addressing modifiable lipid abnormalities if present and monitoring for associated conditions when clinically indicated. (arbuckle2010casereport—papularxanthoma pages 1-3, ramessur2020eruptivepapulesin pages 1-2)

14. Other species / natural disease

No naturally occurring PX analog in non-human species was identified in the retrieved sources.

15. Model organisms

No PX-specific model organisms or induced experimental models were identified in the retrieved sources.

Recent developments and expert-style synthesis (2023–2024 emphasis)

Key 2023 insights

The 2023 case report with literature review consolidates modern understanding that PX can mimic JXG clinically and histologically, provides updated case counts (~53–54 total patients), and emphasizes age-dependent natural history (self-limited in many pediatric cases vs persistence/recurrence and systemic associations more often discussed in adults). (francois2023multiplepapularxanthomas pages 2-2, francois2023multiplepapularxanthomas pages 2-3)

Authoritative clinical perspective (workup and caution)

Eyelid-focused review literature emphasizes that xanthomatous periocular lesions can reflect a spectrum of disorders, some with systemic/malignancy associations, and recommends thorough history, systemic examination, biopsy confirmation, and appropriate imaging when evaluating these presentations. (baykal2017theclinicalspectrum pages 1-2)

Summary tables

The following evidence-map table consolidates the most actionable facts for knowledge base population.

Table (click to expand)
Clinical domain Key facts Quantitative details Evidence
Definition / classification Papular xanthoma (PX) is a rare normolipemic cutaneous non-Langerhans cell histiocytosis and a monomorphous xanthomatized macrophage-predominant reaction pattern within the n-LCH spectrum. It was originally defined by Winkelmann as a distinct xanthogranulomatous/xanthomatous entity. Largest older clinicopathologic series: 10 cases. (breier2002papularxanthomaa pages 1-2, breier2002papularxanthomaa pages 2-4)
Lipid profile status PX is classically described as normolipemic, and diagnostic criteria include a normal lipid profile and no visceral involvement. However, exceptions have been reported, including pediatric cases with lipid abnormalities and historical association with dysbetalipoproteinemia, suggesting the criterion is not absolute. In one pediatric case, triglycerides were 334 mg/dL initially and 241 mg/dL on repeat fasting test; cholesterol 134 mg/dL then 145 mg/dL. (ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2, arbuckle2010casereport—papularxanthoma pages 1-3)
Age of onset patterns PX occurs in both children and adults. Adult series showed a biphasic occurrence in adolescence and middle age. Pediatric disease usually starts in the first year of life, but later childhood onset also occurs. Adult series age range 13-57 years; pediatric onset in ~90% during the first year of life; one case began at age 3 years, another at 4.5 years, another at 10 years. (breier2002papularxanthomaa pages 1-2, ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2, arbuckle2010casereport—papularxanthoma pages 1-3)
Distribution / anatomic sites Lesions are typically yellow to yellow-brown papules/nodules, often on trunk and extremities; head/neck involvement can occur. Pediatric cases often involve head, trunk, and extremities with sparing of mucosa, palms, soles, and usually flexures. Eyelid/periorbital involvement is documented and may appear as flat plaques or papulonodular xanthomatous lesions. In the 10-case series, trunk was most common (50%); 9/10 were solitary and 1/10 disseminated. (breier2002papularxanthomaa pages 1-2, ramessur2020eruptivepapulesin pages 1-2, francois2023multiplepapularxanthomas pages 2-2, choudhary2015papularxanthomain pages 1-2, baykal2017theclinicalspectrum pages 4-6, baykal2017theclinicalspectrum pages 1-2, rebora2011periorbitallesions. pages 4-5)
Histopathology PX shows a well-delimited dermal infiltrate of foamy/xanthomatized histiocytes/macrophages, often with Touton giant cells, a relative absence of inflammatory cells, and no primitive histiocytic phase. Pediatric lesions may lack giant cells and remain monomorphic. Some childhood cases show no multinucleated/Touton giant cells; others show moderate/numerous Touton cells. (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2, francois2023multiplepapularxanthomas pages 2-2, francois2023multiplepapularxanthomas pages 2-3, ramessur2020eruptivepapulesin pages 2-2, breier2002papularxanthomaa pages 1-2, choudhary2015papularxanthomain pages 1-2)
Immunohistochemistry PX usually shows CD68 positivity and is typically S100-negative and CD1a-negative. Factor XIIIa findings are variable across reports: negative in the 10-case adult series and some recent infant data, but positive in at least one pediatric case. In the 2002 series, KiM1p was consistently positive; KP1/CD68 labeled mainly giant cells; HAM56 was variable. Marker pattern summary: CD68+, S100-, CD1a-; FXIIIa variable; KiM1p+ in the adult series. (breier2002papularxanthomaa pages 1-2, breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2, francois2023multiplepapularxanthomas pages 2-2, francois2023multiplepapularxanthomas pages 2-3, choudhary2015papularxanthomain pages 1-2)
Key differential diagnoses Important differentials include juvenile xanthogranuloma (JXG), xanthoma disseminatum (XD), benign cephalic histiocytosis (BCH), Spitz nevus, clear cell acanthoma, xanthoma, atheroma, keloid, histiocytoma, and in some facial cases granulomatous/perioral dermatitis. Distinguishing features rely on biopsy and immunophenotype. JXG is the principal histopathologic mimic; PX differs by monomorphic foamy-cell infiltrate and relative lack of inflammatory cells/primitive phase. (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2, francois2023multiplepapularxanthomas pages 2-2, choudhary2015papularxanthomain pages 1-2, breier2002papularxanthomaa pages 1-2, arbuckle2010casereport—papularxanthoma pages 1-3)
Reported associations PX is usually isolated, but reported associations include mycosis fungoides, Sezary syndrome, later CD3(dim)/CD4+ T-cell lymphoma, dysbetalipoproteinemia, erythrodermic chronic actinic dermatitis, and viral/drug eruptions. Systemic associations remain uncertain overall. Eyelid review documented at least one patient with PX plus mycosis fungoides. (ramessur2020eruptivepapulesin pages 1-2, choudhary2015papularxanthomain pages 1-2, ramessur2020eruptivepapulesin pages 2-2, baykal2017theclinicalspectrum pages 4-6, baykal2017theclinicalspectrum pages 1-2)
Natural history / prognosis Childhood PX is generally self-limited, with lesion flattening and residual hyperpigmentation or anetoderma-like change; adults may show persistent, progressive, or recurrent disease. Observation is typical in children. Childhood lesions often regress within 1-5 years; most regress within 5 years; anetoderma-like scarring reported in up to 60%; one child had improvement over 3 years with no new lesions. (breier2002papularxanthomaa pages 2-4, ramessur2020eruptivepapulesin pages 1-2, francois2023multiplepapularxanthomas pages 2-2, choudhary2015papularxanthomain pages 1-2, ramessur2020eruptivepapulesin pages 2-2)
Epidemiology / case counts PX is very rare, with literature estimates differing by review date and inclusion criteria. Older and newer reviews consistently indicate only a few dozen documented patients. Older review: 43 cutaneous cases before the 2002 series; 2023 review states 53 reported patients with 35 in four comprehensive series and 18 with follow-up (median 28 months, mean 41.3 months); another 2023 summary states 22 reports / 54 patients. (breier2002papularxanthomaa pages 2-4, francois2023multiplepapularxanthomas pages 2-2, francois2023multiplepapularxanthomas pages 2-3, breier2002papularxanthomaa pages 1-2)
Suggested workup from reported practice Reported evaluation includes fasting lipid profile, CBC/basic labs, serum protein electrophoresis, assessment for visceral/systemic involvement, skin biopsy with histology and immunohistochemistry, and when periocular disease is present, broader dermatologic/systemic assessment. Pediatric workups included normal abdominal ultrasound/chest X-ray in one case and normal liver/spleen ultrasound in another. (ramessur2020eruptivepapulesin pages 1-2, arbuckle2010casereport—papularxanthoma pages 1-3, choudhary2015papularxanthomain pages 1-2, baykal2017theclinicalspectrum pages 1-2)

Table: This table compiles the main clinically actionable facts about papular xanthoma from the provided evidence, including phenotype, pathology, immunohistochemistry, associations, prognosis, and reported case statistics. It is useful as a compact evidence map for building a disease knowledge base entry.

Key evidence-supported “abstract-quote” style statements (verbatim from retrieved texts)

  • Pediatric PX course statistics: “In 90% of cases, the skin lesions have their onset during the first year of life and most regress within five years.” (ramessur2020eruptivepapulesin pages 1-2)
  • Pediatric sequelae: “Anetoderma-like scars have been reported after resolution of lesions in up to 60% of cases.” (ramessur2020eruptivepapulesin pages 1-2)
  • 2002 rarity estimate: “Until now, 43 cases of cutaneous PX have been described …” (breier2002papularxanthomaa pages 2-4)
  • Periorbital location statement: “Papular xanthoma is a rare entity characterized by yellowish papulonodular lesions, clinically indistinguishable from those of juvenile xanthogranuloma, often located around the eyes.” (rebora2011periorbitallesions. pages 4-5)

Limitations of this report

  • Formal disease identifiers (MONDO/Orphanet/ICD/MeSH/OMIM) and PMIDs were not present in the retrieved excerpts and therefore could not be cited here.
  • Genetics/omics/pathway-level mechanisms for PX were not found in the retrieved corpus.
  • Treatment evidence is limited mainly to observation in children and sparse case-level reports; no clinical trials were identified.

References

  1. (francois2023multiplepapularxanthomas pages 2-2): Rony A. Francois, Grant J. Randall, Eric W. Rudnick, Stephanie J. Carstens, and Vladimir Vincek. Multiple papular xanthomas mimicking juvenile xanthogranulomas in an infant: a case report and review of the literature. Journal of Cutaneous Pathology, 50:1-7, May 2023. URL: https://doi.org/10.1111/cup.14244, doi:10.1111/cup.14244. This article has 0 citations and is from a peer-reviewed journal.

  2. (breier2002papularxanthomaa pages 1-2): Friedrich Breier, Bettina Zelger, Harald Reiter, Friedrich Gschnait, and Bernhard W. H. Zelger. Papular xanthoma: a clinicopathological study of 10 cases. Journal of Cutaneous Pathology, 29:200-206, Apr 2002. URL: https://doi.org/10.1034/j.1600-0560.2002.290402.x, doi:10.1034/j.1600-0560.2002.290402.x. This article has 52 citations and is from a peer-reviewed journal.

  3. (ramessur2020eruptivepapulesin pages 1-2): Ravi Ramessur, George Meligonis, and Nigel P. Burrows. Eruptive papules in a 4‐year‐old girl. Pediatric Dermatology, Jan 2020. URL: https://doi.org/10.1111/pde.14023, doi:10.1111/pde.14023. This article has 0 citations and is from a peer-reviewed journal.

  4. (breier2002papularxanthomaa pages 2-4): Friedrich Breier, Bettina Zelger, Harald Reiter, Friedrich Gschnait, and Bernhard W. H. Zelger. Papular xanthoma: a clinicopathological study of 10 cases. Journal of Cutaneous Pathology, 29:200-206, Apr 2002. URL: https://doi.org/10.1034/j.1600-0560.2002.290402.x, doi:10.1034/j.1600-0560.2002.290402.x. This article has 52 citations and is from a peer-reviewed journal.

  5. (baykal2017theclinicalspectrum pages 1-2): Can Baykal, Algun Polat Ekinci, Kurtulus D. Yazganoglu, and Nesimi Buyukbabani. The clinical spectrum of xanthomatous lesions of the eyelids. International Journal of Dermatology, 56:981-992, May 2017. URL: https://doi.org/10.1111/ijd.13637, doi:10.1111/ijd.13637. This article has 38 citations and is from a peer-reviewed journal.

  6. (arbuckle2010casereport—papularxanthoma pages 1-3): Alan Arbuckle and Lori D. Prok. Case report—papular xanthoma in a 10‐year‐old female with abnormal lipid profile. Pediatric Dermatology, 27:86-88, Jan 2010. URL: https://doi.org/10.1111/j.1525-1470.2009.01054.x, doi:10.1111/j.1525-1470.2009.01054.x. This article has 9 citations and is from a peer-reviewed journal.

  7. (choudhary2015papularxanthomain pages 1-2): Nidhi Choudhary, Shruti Jadhav, Rahul Ahar, Arghyaprasun Ghosh, Joydeep Singha, and Archana Saha. Papular xanthoma in a child: report of a rare entity. Indian Journal of Paediatric Dermatology, 16:78-80, Apr 2015. URL: https://doi.org/10.4103/2319-7250.152139, doi:10.4103/2319-7250.152139. This article has 2 citations.

  8. (rebora2011periorbitallesions. pages 4-5): Alfredo Rebora. Periorbital lesions. Clinics in dermatology, 29 2:151-6, Mar 2011. URL: https://doi.org/10.1016/j.clindermatol.2010.09.006, doi:10.1016/j.clindermatol.2010.09.006. This article has 9 citations and is from a peer-reviewed journal.

  9. (francois2023multiplepapularxanthomas pages 2-3): Rony A. Francois, Grant J. Randall, Eric W. Rudnick, Stephanie J. Carstens, and Vladimir Vincek. Multiple papular xanthomas mimicking juvenile xanthogranulomas in an infant: a case report and review of the literature. Journal of Cutaneous Pathology, 50:1-7, May 2023. URL: https://doi.org/10.1111/cup.14244, doi:10.1111/cup.14244. This article has 0 citations and is from a peer-reviewed journal.

  10. (baykal2017theclinicalspectrum pages 4-6): Can Baykal, Algun Polat Ekinci, Kurtulus D. Yazganoglu, and Nesimi Buyukbabani. The clinical spectrum of xanthomatous lesions of the eyelids. International Journal of Dermatology, 56:981-992, May 2017. URL: https://doi.org/10.1111/ijd.13637, doi:10.1111/ijd.13637. This article has 38 citations and is from a peer-reviewed journal.

  11. (ramessur2020eruptivepapulesin pages 2-2): Ravi Ramessur, George Meligonis, and Nigel P. Burrows. Eruptive papules in a 4‐year‐old girl. Pediatric Dermatology, Jan 2020. URL: https://doi.org/10.1111/pde.14023, doi:10.1111/pde.14023. This article has 0 citations and is from a peer-reviewed journal.