The Role of Atorvastatin in Management of Eruptive Xanthoma on a Boy: A Case Report

Authors

  • Harapan Parlindungan Ringoringo Department of Child Health, Faculty of Medicine, Lambung Mangkurat University – RSD Idaman, Banjarbaru, Indonesia https://orcid.org/0000-0001-5678-0059

DOI:

https://doi.org/10.3889/oamjms.2021.6941

Keywords:

Case report, Eruptive xanthoma, Hypertriglyceridemia, Atorvastatin

Abstract

Background: Eruptive xanthoma is a benign skin lesion caused by the accumulation of cholesterol and triglycerides in the skin's dermis. Xanthoma can be an early clinical manifestation of systemic diseases such as dyslipidemia, cardiovascular disease, diabetes mellitus. Clinical presentation varies from asymptomatic skin lesions to intense pruritus and tenderness.

Aim: This study aims that oral atorvastatin is effective in treating a child with eruptive xanthoma.

Case report: A three-year-old boy with an 8.4 kg body weight and 82.5 cm height came to the hospital with the chief complaint of small yellowish-white papules and nodes, discrete, 2-5 mm in size, painless on pressing, itchy, scattered, mainly in the lower extremity around the buttocks. On laboratory examination, Hb 11.5 g/dL, leukocyte 9,900/ul, platelet 413,000/uL, blood glucose 66 mg/dL. Further evaluation revealed total cholesterol 814 mg/dL, LDL 970 mg/dL, HDL 341 mg/dl, triglycerides 621 mg/dL; there is no evidence of familial hypercholesterolemia. The diagnosis is eruptive xanthoma.  After starting treatment with atorvastatin 0.2 mg/kg body weight/day in one dose for six months, his cutaneous lesions gradually subsided and significantly decreased cholesterol, LDL, HDL, and triglyceride levels. Conclusion: Early therapy with atorvastatin will reduce the morbidity and mortality of eruptive xanthoma.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Kashif M, Kumar H, Khaja M. An unusual presentation of eruptive xanthoma: A case report and literature review. Medicine (Baltimore). 2016;95(37):e4866. https://doi.org/10.1097/md.0000000000004866 PMid:27631252 DOI: https://doi.org/10.1097/MD.0000000000004866

Zak A, Zeman M, Slaby A, Vecka M. Xanthomas: Clinical and pathophysiological relations. Biomed Pap. 2014;158(2):181-8. https://doi.org/10.5507/bp.2014.016 PMid:24781043 DOI: https://doi.org/10.5507/bp.2014.016

Crocker AC. Special reviews: Skin xanthomas in childhood. Pediatrics. 1951;8(4):573-97. PMid:14882914

Odeh AA. Xanthoma in a child as the first presentation of type one diabetes mellitus. Pediatr Ther. 2015;5:226.

Teltscher J, Silverman RA, Stork J. Eruptive xanthomas in a child with the nephrotic syndrome. J Am Acad Dermatol. 1989;21(5 Pt 2):1147-9. https://doi.org/10.1016/s0190-9622(89)70319-4 PMid:2808850 DOI: https://doi.org/10.1016/S0190-9622(89)70319-4

Parker F. Xanthomas and hyperlipidemias. J Am Acad Dermatol. 1985;13(1):1-30. PMid:4031142 DOI: https://doi.org/10.1016/S0190-9622(85)70139-9

Zaremba J, Zaczkiewicz A, Placek W. Eruptive xanthomas. Adv Dermatol Allergol. 2013;6(6):399-402. https://doi.org/10.5114/pdia.2013.39439 PMid:24494004 DOI: https://doi.org/10.5114/pdia.2013.39439

Maria VR, Maria OC. Dyslipidemia in Children with Acute Malnutrition. Turbo, Colombia. Perspect Nut Hum vol14 no2 Medellín July/Dec 2012; 2012.

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics. 2011;128(Suppl 5):S213-56. https://doi.org/10.1542/peds.2009-2107c PMid:22084329 DOI: https://doi.org/10.1542/peds.2009-2107C

Nikolic D, Corina A, Toth PP, Hammad L, Rizzo M. Choosing an ideal pharmacotherapeutic strategy for dyslipidemia in children. Expert Opin Pharmacother. 2019;20(3):241-4. https://doi.org/10.1080/14656566.2018.1552942 PMid:30521406 DOI: https://doi.org/10.1080/14656566.2018.1552942

Brown MS, Goldstein JL. A receptor-mediated pathway for cholesterol homeostasis. Science. 1986;232(4746):34-47. https://doi.org/10.1126/science.3513311 PMid:3513311 DOI: https://doi.org/10.1126/science.3513311

Ness GC, Chambers CM, Lopez D. Atorvastatin action involves diminished recovery of hepatic HMG-CoA reductase activity. J Lipid Res. 1998;39(1):75-84. https://doi.org/10.1016/s0022-2275(20)34205-x PMid:9469588 DOI: https://doi.org/10.1016/S0022-2275(20)34205-X

Labos C, Brophy JM, Smith GD, Sniderman AD, Thanassoulis G. Evaluation of the pleiotropic effects of statins. Arterioscler Thromb Vasc Biol. Am Heart Assoc. 2018;38:262-5. DOI: https://doi.org/10.1161/ATVBAHA.117.310052

Khoury M, McCrindle BW. The rationale, indications, safety, and use of statins in the pediatric population. Can J Cardiol. 2020;36(9):1372-83. https://doi.org/10.1016/j.cjca.2020.03.041 PMid:32735868 DOI: https://doi.org/10.1016/j.cjca.2020.03.041

Luirink IK, Wiegman A, Kusters DM, Hof MH, Groothoff JW, de Groot E, et al. 20-year follow-up of statins in children with familial hypercholesterolemia. N Engl J Med. 2019;381(16):1547-56. https://doi.org/10.1056/nejmoa1816454 PMid:31618540 DOI: https://doi.org/10.1056/NEJMoa1816454

Downloads

Published

2021-09-15

How to Cite

1.
Ringoringo HP. The Role of Atorvastatin in Management of Eruptive Xanthoma on a Boy: A Case Report. Open Access Maced J Med Sci [Internet]. 2021 Sep. 15 [cited 2024 Nov. 21];9(C):151-3. Available from: https://oamjms.eu/index.php/mjms/article/view/6941

Issue

Section

Case Report in Pediatrics

Categories