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eruptive xanthoma; eruptive xanthelasma

Etiology: - hyperliproteinemia with hypertriglyceridemia - hyperlipoproteinemia type 1 [1,2] - hyperlipoproteinemia type 3 - hyperlipoproteinemia type 4 - hyperlipoproteinemia type 5 [2] - diabetes mellitus type 2 with severe hypertriglyceridemia [4] (xanthoma diabeticorum) Pathology: - localized lipid deposits Clinical manifestations: 1) initially commonly appearing as erythematous papules, on the buttocks & proximal (extensor) regions of the extremities 2) onset may be abrupt 3) crops of 1-5 mm yellow-orange papules with surrounding erythema on extensor surfaces of the extremities & buttocks [2] 4) lesions last several weeks until plasma triglycerides are reduced * images [2,4] Laboratory: - xanthomas appear when plasma triglycerides exceed 2 g/dL Management: - treat hyperlipidemia - usually responds well to triglyceride-lowering treatment - complete resolution of the lesions is common [4] - laser therapy or cyrotherapy [2]

Related

hyperlipoproteinemia type 1; familial hyperchylomicronemia

Specific

xanthoma diabeticorum

General

xanthoma

References

  1. Tietz Textbook of Clinical Chemistry, 2nd ed. Burtis CA & Ashwood ER (eds), WB Saunders Co, Philadelphia PA, 1993, pg 1035
  2. Rashid RM, Barros BS (images) Hidden Heart Disease: 19 Dermatologic Clues You Should Know. Medscape. June 13, 2017. http://reference.medscape.com/slideshow/hidden-heart-disease-6004452
  3. Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
  4. NEJM Knowledge+ Question of the Week. Oct 6, 2020 https://knowledgeplus.nejm.org/question-of-week/826/a - Kala J, ostow EN. Images in clinical medicine. Eruptive xanthoma. N Engl J Med 2012 Mar 2; 366:835 PMID: 22375975 Free articl https://www.nejm.org/doi/full/10.1056/NEJMicm1105301