Xanthomas of the Achilles Tendon

Spend enough time on planet earth, and you’ll probably experience your fair share of lumps and bumps on the feet and ankles, from soft tissue injuries like blisters and warts to bony enlargements such as bunions. Sometimes they hurt and sometimes they don’t. Sometimes they require immediate treatment and sometimes they can be left alone. But you should always carefully monitor your feet and report any strange issues—your body could be telling you something important.

Xanthomas are somewhat uncommon soft lumps that appear around tendons. These bumps tend to be small, relatively flat, and often have a yellowish color.

Symptoms of Xanthomas

The soft nodules themselves are caused by a buildup of fatty tissues known as lipids in the skin, usually due to elevated levels of cholesterol and/or triglycerides in the bloodstream. Although often yellowish, they may also appear closer to white in color and have a waxy feel.

They often appear in bunches, and can develop anywhere on the body, including your hands, knees, elbows, or buttocks. When they appear in the lower limbs, they’re often (although not always) located along the back of the heel, on the lower portion of the Achilles tendon.

Underlying Causes and Complications

The good news is that xanthomas themselves are generally harmless and not painful in and of themselves. They should not affect the function of your feet and ankles in any way, either.

However, their presence in the skin generally indicates a much more serious underlying disease. This might include a hereditary metabolic disorder such as familiar hypercholesterolemia, or other conditions such as diabetes, cancer, cirrhosis, or hyperlipidemia. These conditions require immediate medical intervention. High cholesterol is linked to a greatly increased risk of heart disease and heart attack, so seeking treatment isn’t just a good idea—it could save or significantly prolong your life.

Diagnosis and Treatment

Xanthomas may be diagnosed with a physical examination, although we may run some additional tests to be sure (such as testing for cholesterol in the bloodstream).

The most pressing need is to treat the underlying condition aggressively. Since the nodules themselves are harmless, they’re often left alone, at least initially.

Treatment varies based on the underlying condition, but prescription medications to control cholesterol are common, as well as changes in diet or nutritional intake. If your condition requires a referral to another specialist or a family practice doctor, we’ll be happy to make one.

In many cases, conservative care for the underlying condition will cause the xanthoma lumps themselves to subside in time.

If you notice any signs of a lump that could be a xanthoma, do not wait to contact Dr. Harvey Danciger. Your health is our top priority and a prompt diagnosis allows for a faster recovery. Call our Palm Desert, CA office at (760) 568-0108 or schedule an appointment online

Dr. Harvey Danciger
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Dr. Harvey Danciger is a podiatrist and foot surgeon in Palm Desert, CA specializing in the foot and ankle