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JAMA. 1929;92(10):808. doi:10.1001/jama.1929.02700360046012.
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In a discussion of xanthoma at the meeting of the American Dermatological Association last year, Professor Bloch of Zurich remarked that heretofore this has been one of the few metabolic diseases of the skin about which a simple explanation seemed to be available. It has been assumed that a pathologic metabolism of cholesterol underlies the development of xanthomatous lesions. The commonest hypothesis postulated that there may be some fundamental hepatic disturbance followed by hypercholesterolemia, and that the deposit of cholesterol in the xanthomatous tissue is a simple consequence of the latter. Different writers have alleged that xanthomatous masses of various kinds all seem to be composed of deposits of esters of cholesterol as a sequel of protracted hypercholesterolemia, the deposits leading in turn to proliferative and phagocytic reactions in the fixed tissues. The explanation has also been ventured that xanthomatous tumors are due to a peculiar affinity of a cell


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