Eruptive Xanthomas Associated With Olanzapine Use

Chang, Howard Y.; Ridky, Todd W.; Kimball, Alexa B.; Hughes, Elizabeth C.; Oro, Anthony E.

doi:10.1001/archderm.139.8.1045

Cited by 31 publications

(14 citation statements)

References 29 publications

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“…Este fármaco atua Figura 2 -Histologia das lesões com numerosos histiócitos xantomizados com citoplasma abundante, acompanhados de infiltrado inflamatório linfomononucleado circundante através da inibição da recaptação de serotinina que tem um duplo papel no metabolismo da glicose: a nível central, reduzindo a resposta à hiperglicemia, e perifericamente nas células pancreáticas, diminuindo a secreção de insulina. [7][8][9] Este antagonismo provocado pela olanzapina resulta numa insuficiência relativa de insulina, com interferência no metabolismo da glicose e das lipoproteínas, levando à formação de XE. 9,10 Este mecanismo parece necessitar de um defeito pré-existente na secreção de insulina, 7 tal como no nosso caso clínico.…”

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Xantomas Eruptivos: Manifestação Cardinal de Distúrbio Metabólico Grave

2018

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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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Section: Discussionunclassified

“…[7][8][9] Este antagonismo provocado pela olanzapina resulta numa insuficiência relativa de insulina, com interferência no metabolismo da glicose e das lipoproteínas, levando à formação de XE. 9,10 Este mecanismo parece necessitar de um defeito pré-existente na secreção de insulina, 7 tal como no nosso caso clínico.…”

Section: Discussionunclassified

Xantomas Eruptivos: Manifestação Cardinal de Distúrbio Metabólico Grave

2018

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“…5 In adults, heavy alcohol intake and medications that increase endogenous triglycerides have been associated with eruptive xanthomas, most commonly estrogens, isotretinoin, glucocorticoids, olanzapine, and antiretroviral agents. 6,7 The selective serotonin reuptake inhibitor medications sertraline and citalopram may increase triglyceride levels, and eruptive xanthomas have been described in patients taking sertraline. [8][9][10] Although our patient' s hypertriglyceridemia was evident before starting either sertraline or citalopram, we speculate that these medications may have exacerbated the hypertriglyceridemia.…”

Section: Figurementioning

confidence: 99%

Eruptive Xanthomas Masquerading as Molluscum Contagiosum

Sorrell

Salvaggio²,

Garg

et al. 2014

Pediatrics

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Eruptive Xanthomas Masquerading as Molluscum Contagiosum abstractEruptive xanthomas are cutaneous manifestations of hyperlipidemias in which lipids accumulate in large foam cells within the skin. They classically present as crops of 1-to 4-mm yellow-orange papules and are often associated with extreme hypertriglyceridemia. We describe a 12-year-old boy with autism who was thought to have widespread molluscum contagiosum for a year before dermatologic consultation was obtained. Recognition of eruptive xanthomas led to the discovery of massive hypertriglyceridemia (serum triglycerides 6853 mg/dL) and diabetes mellitus. Through medical intervention, including insulin and fenofibrate therapy, and dietary modification with weight loss, the xanthomas cleared during the subsequent months, and his serum triglyceride levels nearly normalized. Pediatrics 2014;134: e257-e260 AUTHORS:

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“…Type II DM and use of antipsychotic agents, as seen in our patient, have been associated with increased incidence of xanthomas. 2,3 Our patient was managed with adequate glycemic control by initiation of insulin therapy and gemfibrozil as well as discontinuation of the offending antipsychotic agent. …”

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confidence: 99%