A Colorful Enigma: A Case of Orange Palpebral Spots in a 63-Year-Old Woman

Orange-yellow discoloration of the eyelids suggests lipid deposition in the dermis, leading to differentials including xanthelasma and carotenoderma. Biopsies of OPS show increased lipid deposition without xanthelasma's characteristic lipid-laden macrophages, also described as foamy histiocytes. Carotenoderma primarily affects sweat and sebum, leading to pigmentation in specific areas, like palms, soles, and nasolabial folds. Though the cause of OPS is unknown, factors like microscopic fat cells, increased pigments, and local trauma, are implicated. However, further research is needed to determine the etiology. Orange palpebral spots remain poorly recognized, with no established treatments, underscoring the need for accurate diagnosis to avoid unnecessary biopsies and provide reassurance to patients.