Eruptive xanthomas as a marker for metabolic disorders: A specific form of xanthoma that reflects hypertriglyceridemia

Abstract

Eruptive xanthomas are skin manifestations associated with hypertriglyceridemia. Accordingly, the improvement of hypertriglyceridemia can ameliorate this condition. We report a case of a patient with type 2 diabetes mellitus who was diagnosed with this skin lesion. Clinicians should be aware that eruptive xanthomas could indicate metabolic disorders associated with atherosclerosis.

Eruptive xanthoma as a warning sign of uncontrolled hypertriglyceridemia presenting with acute pancreatitis and uncontrolled type II diabetes mellitus: A case report

“…Xanthomas are identified histologically by the presence of extracellular lipid deposits and the growth of foam cells. 5 They may arise in individuals with primary hypertriglyceridemia or secondary conditions like uncontrolled diabetes, alcohol abuse, or medication usage. Uncontrolled diabetes can contribute to elevated triglyceride levels, increased concentrations of VLDL and chylomicrons, and potentially trigger hypertriglyceridemia pancreatitis.…”

Eruptive xanthomas

“…Severe abnormalities in the triglyceride metabolism are a risk factor for the development of eruptive xanthomas 1. Untreated abnormalities of underlying lipid metabolism are associated with acute complications (eg, acute pancreatitis) and chronic accelerated atherosclerosis with cardiovascular disease 2 3. Eruptive xanthoma can result from deficiency of lipoprotein lipase activity (as in patients with lipoprotein lipase deficiency (type I hyperlipoproteinemia), dysfunctional apolipoprotein C-II or impaired insulin activity), or from overproduction by the liver of triglyceride-rich lipoproteins (as in endogenous familial hypertriglyceridemia (type IV hyperlipoproteinemia) or from the elevations of both chylomicrons and very-low-density lipoproteins of type V hyperlipoproteinemia 4 5.…”

Eruptive xanthoma associated with hypertriglyeridaemia and diabetes

“…Eruptive xanthoma is not a simple dermatoses, but a significant indicator of systemic metabolic disorders. 2 Severe hypertriglyceridaemia is considered the highest risk factor for the development of eruptive xanthoma, with approximately 8.5% of patients having triglyceride concentrations >20 mmol/L. 2 Hypertriglyceridaemia can be caused by primary disease, mainly hereditary diseases like lipoprotein lipase deficiency, familial hypertriglyceridaemia and familial combined hyperlipidaemia.…”

“…2 Severe hypertriglyceridaemia is considered the highest risk factor for the development of eruptive xanthoma, with approximately 8.5% of patients having triglyceride concentrations >20 mmol/L. 2 Hypertriglyceridaemia can be caused by primary disease, mainly hereditary diseases like lipoprotein lipase deficiency, familial hypertriglyceridaemia and familial combined hyperlipidaemia. It also can result from secondary factors, including obesity, alcohol abuse, uncontrolled diabetes, hypothyroidism and some medications, such as systemic glucocorticoids, retinoids, cyclosporine, exogenous oestrogens and antiretroviral drugs.…”

“…The accumulation of foam cells and extracellular lipid deposits are the key characteristics of eruptive xanthoma. 2 In addition, doctors should be alert to the occurrence of possible concomitant conditions, such as acute hyperlipidaemic pancreatitis and diabetic ketoacidosis or hyperglycaemic hyperosmotic coma.…”