Eruptive Xanthomas: A Cardinal Manifestation of Serious Metabolic Disease

Authors

  • Luis Santiago Serviço de Dermatologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • André Pinho Serviço de Dermatologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • José Carlos Cardoso Serviço de Dermatologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.

DOI:

https://doi.org/10.20344/amp.9126

Keywords:

Hypertriglyceridemia, Olanzapine, Skin Diseases, Xanthomatosis

Abstract

Eruptive cutaneous xanthomas develop as a result of rapid intracellular and dermal deposition of lipids and are a cardinal sign of high cardiovascular risk. We describe the case of a 47-year-old male with multiple dome-shaped, yellowish and firm, slightly pruriginous papules distributed over the buttocks, lumbar region, abdominal wall, elbows and neck, for about two months. Previous medical history included alcohol abuse, non-medicated type 2 diabetes mellitus, dyslipidemia and recent onset of therapy with olanzapine for depressive syndrome. Work-up revealed hypertriglyceridemia (7474 mg/dL), hypercholesterolemia (1054 mg/dL) and hemoglobin A1c of 12.1%. Histopathologic examination of an abdominal papule showed clusters of foamy histiocytes in the dermis confirming the diagnosis of eruptive xanthomas. In this case, the introduction of olanzapine may have aggravated the previous history of metabolic disease which may have led to the rapid onset of skin lesions. Proper recognition of eruptive xanthomas can have a profound impact on diagnosis, treatment and prognosis of patients who suffer from an underlying systemic disease.

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Published

2018-04-30

How to Cite

1.
Santiago L, Pinho A, Cardoso JC. Eruptive Xanthomas: A Cardinal Manifestation of Serious Metabolic Disease. Acta Med Port [Internet]. 2018 Apr. 30 [cited 2023 Oct. 2];31(4):219-22. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9126

Issue

Section

Case Report