Rare and unusual presentation of periorbital xanthelasma

This report presents a sixty year old female with unusual appearance of bilateral xanthelasma palpebrarum of periorbital region. These lesions were approximately 7 cm x 3 cm in dimensions. Patient’s main complaints were aesthetic appearance and hindrance in downward gaze. Considering the size of the lesions surgical excision was planned and the raw area covered with full thickness skin grafts from supra clavicular region. The aesthetic and functional outcome was good. The aim of this case report is to put forward an unusual presentation of xanthelasma, at the same time to keep in mind the surgical excision with full thickness skin grafting as an excellent treatment modality for periorbital xanthelasma palpebrarum especially in large lesions where other modalities have their own limitations.