Impact of Systematic Nursing Education and Psychological Intervention on Anxiety Reduction and Treatment Outcomes in Patients with Xanthelasma Treated with PingyangmycinRunning Title: Findings from a prospective cohort of 228 patients (Preprint)

<sec> <title>BACKGROUND</title> Xanthelasma palpebrarum (XP) is the most common subtype of cutaneous xanthoma, accounting for more than 95% of cases. Its incidence is increasing and parallels the global rise in obesity. As XP causes conspicuous cosmetic disfigurement, affected patients frequently experience anxiety. </sec> <sec> <title>OBJECTIVE</title> In this study, we investigated the efficacy of intralesional pingyangmycin injection for XP and evaluated the impact of systematic nursing education and psychological intervention on anxiety reduction and treatment outcomes. </sec> <sec> <title>METHODS</title> A total of 228 patients with XP (398 lesions) treated between December 2024 and August 2025 were enrolled. All patients underwent intralesional pingyangmycin injection and completed psychological assessments using the Hospital Anxiety and Depression Scale (HADS) at baseline and 1month post-treatment. Systematic nursing education, including injection-related care, postoperative recovery guidance, and emotional support, was provided throughout the treatment process. </sec> <sec> <title>RESULTS</title> Treatment outcomes showed that 63.31% of lesions achieved complete remission, 23.87% showed improvement, and 2.27% were ineffective. Psychological intervention significantly reduced both anxiety and depression scores (P &lt; 0.001). Furthermore, reductions in anxiety were positively associated with improved treatment outcomes, including a lower incidence of complications and higher patient satisfaction. </sec> <sec> <title>CONCLUSIONS</title> Intralesional pingyangmycin injection is an effective treatment for XP. When combined with psychological intervention and structured nursing education, it not only alleviates anxiety but also enhances treatment compliance and patient satisfaction, thereby optimizing overall therapeutic outcomes. </sec>