Eruptive Xanthomas: Importance of Recognition to Reduce Delay of Effective Triglyceride Reduction.

Abstract

Eruptive xanthomas are localized lipid deposits in the dermis and an important early clue to severe hypertriglyceridemia. These small erythematous or yellow papules that localize to the extensor surfaces of extremities, buttocks, and the back are often overlooked during routine visits secondary to poor familiarity and limited skin examinations. We present 3 cases of patients with eruptive xanthomas and severe hypertriglyceridemia who underwent skin biopsy and waited weeks to years before receiving effective treatment. We suggest the following to minimize the delay between presentation and effective management. First, perform a comprehensive skin examination. Second, be mindful of the association between metabolic syndrome or diabetes with severe hypertriglyceridemia. Third, evaluate the Four D's of secondary hypertriglyceridemia: Diet/Lifestyle, Drugs/Medications, and Diseases/Disorders of metabolism. Finally, initiate effective treatment promptly after recognition. This includes beginning with a minimal fat diet and appropriate pharmacological intervention to control triglycerides as outlined in recent guidelines.

• Authors: Emily P Marogi, Ramael O Ohiomoba, Neil J Stone
• Journal: The American journal of medicine (Am J Med) Vol. 135 Issue 4 Pg. 444-447 (04 2022) ISSN: 1555-7162 [Electronic] United States
• PMID: 34732347 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Chemical References

• Triglycerides

Topics

• Diabetes Mellitus
• Humans
• Hyperlipidemias (complications)
• Hypertriglyceridemia (complications, diagnosis)
• Skin (pathology)
• Triglycerides
• Xanthomatosis (complications, etiology)