Xanthomata Secondary to Hypertriglyceridemia

April 3, 2012

A 57-year-old obese woman with known and poorly controlled type 2 diabetes presented with the sudden onset of “yellow bumps all over.” Representative lesions on the back and elbows are shown.

A 57-year-old obese woman with known and poorly controlled type 2 diabetes presented with the sudden onset of “yellow bumps all over.” Representative lesions on the back and elbows are shown.

Key point: This history and clinical picture are nearly pathognomonic for eruptive xanthomas (or xanthomata). Such lesions typically erupt as crops of small, red-yellow papules, most commonly on the buttocks, shoulders, arms, and legs. Lesions may be tender or pruritic. This is a sign of primary or secondary hypertriglyceridemia.

Treatment: Hypertriglyceridemia should be sought and managed (by diet and drugs).

Note: If the patient is not already known to be diabetic, glucose intolerance should be strongly suspected and investigated, since most cases are seen in conjunction with diabetes.