10.5826/dpc.1301a25
text/xml
2160-9381
2562
en
Elizabeth Leocadia Fernandes
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
eruptive xanthoma, hypertriglyceridemia, dermoscopy, xanthomatosis
Eruptive Xanthoma as a Sign of Underlaying Severe Metabolic Disorder
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-01-31
2022-04-28
2023-01-31
2023-03-01
e2023025
Dermatol Pract Concept
Elizabeth Leocadia Fernandes
2023/01/31
10.5826/dpc.1301a25
e2023025
Dermatoscopy and Melanoma clinic at UNITAU; Brazilian Society of Dermatology; International Dermoscopy Society, Brazil
2160-9381
eruptive xanthoma, hypertriglyceridemia, dermoscopy, xanthomatosis
en
e2023025
Nessel TA, Kerndt CC, Bills JA, Sikorski L. Eruptive xanthomas: a warning sign of future hyperlipidemia complications. Int J Res Dermatol 2020;6:579-83. doi:10.18203/issn.2455-4529
Eruptive Xanthoma as a Sign of Underlaying Severe Metabolic Disorder
https://dpcj.org/index.php/dpc/article/download/2562/1956
          Eruptive Xanthoma as a Sign of Underlaying
                   Severe Metabolic Disorder
                           Jordana Rigolon de Lara1, Gabriela Momente Miquelin2,
                                  Jan Lapins4, Elizabeth Leocadia Fernades3


1 University of Mogi das Cruzes (UMC), Brazil
2 University of Mogi das Cruzes (UMC); Brazilian Society of Dermatology, Brazil
3 Dermatoscopy and Melanoma clinic at UNITAU; Brazilian Society of Dermatology; International Dermoscopy Society, Brazil
4 Departament of Dermatology, Karolinska University Hospital and Karolinska Institutet, Sweden



Keywords: eruptive xanthoma, hypertriglyceridemia, dermoscopy, xanthomatosis
Citation: Rigolon de Lara J, Momente Miquelin G, Lapins J, Leocadia Fernades E. Eruptive Xanthoma as a Sign of Underlaying Severe
Metabolic Disorder. Dermatol Pract Concept. 2023;13(1):e2023025. DOI: https://doi.org/10.5826/dpc.1301a25
Accepted: May 1, 2022; Published: January 2023
Copyright: ©2023 Rigolon de Lara et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Jordana Rigolon de Lara, Av. Prefeito Carlos Ferreira Lopes, 635, Apto 172, ZIP code: 08773-490,
Mogi das Cruzes - SP, Brazil. E-mail: jordanarigolon@gmail.com




Case Presentation                                                        small, yellow, cutaneous papules, 1-4 mm in diameter, with
                                                                         an erythematous halo around the base. They appear sud-
A 40-year-old woman presented with a 2 year history of                   denly in crops over pressure points and extensor surfaces
multiple asymptomatic yellow-erythematous papules and                    of the arms, legs, and buttocks. These forms of xanthomas
plaques on the upper limbs, extending to the trunk and                   develop exclusively in the presence of lactescent plasma and
lower limbs. Dermatoscopy showed aggregates of white to                  severe hypertriglyceridemia [1].
yellow clods on a structureless pink background. History of                   Hypertriglyceridemia causes morbidity and mortality by
type 2 diabetes mellitus. Laboratory abnormalities occurred:             significantly increasing the risk of atherosclerosis, cardiovas-
triglycerides 6137 mg/dl (0-149 mg/dl), glucose 317 mg/dl                cular disease and stroke. In addition, there is an increased
(65-99 mg/dl). Histopathological examination revealed xan-               risk of acute pancreatitis [2].
thomatous cells with immunohistochemistry: CD68+ in nu-                       It is therefore very important to recognize the clinical and
merous histiocytes, compatible with eruptive xanthoma.                   dermatoscopic features of the cutaneous presentation of this
                                                                         severe metabolic disease and request adequate laboratory
Teaching Point                                                           workup and initiate appropriate treatment.

Eruptive xanthomas develop in cases of pronounced and
abrupt onset hypertriglyceridemia and are characterized by




Image Letter | Dermatol Pract Concept. 2023;13(1):e2023025                                                                                1
Figure 1. (A, B) Multiple yellow-erythematous papules and plaques. (C) Dermatoscopy showed aggregates of white to yellow clods on a
structureless pink background.




References                                                          2. Nessel TA, Kerndt CC, Bills JA, Sikorski L. Eruptive
                                                                       ­xanthomas: a warning sign of future hyperlipidemia compli-
 1. Parker F. Xanthomas and hyperlipidemias. J Am Acad Derma-           cations. Int J Res Dermatol. 2020;6:579-583. DOI:10.18203/
    tol. 1985;13(1):1-30. DOI:10.1016/s0190-9622(85)70139-9.            issn.2455-4529.
    PMID: 4031142.




2                                                                         Image Letter | Dermatol Pract Concept. 2023;13(1):e2023025
