Eruptive Xanthomas – Two Case Reports With Distinct Features

Authors

  • Uwe Wollina Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany
  • André Koch Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany
  • Gesina Hansel Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany
  • Jacqueline Schönlebe Institute of Pathology "Georg Schmorl", Städtisches Klinikum Dresden, Dresden, Germany

DOI:

https://doi.org/10.3889/oamjms.2018.458

Keywords:

Eruptive Xanthomas, Metabolic Disorders, Chylomicronemia, Diabetes mellitus, Hyperlipidemia

Abstract

BACKGROUND: Eruptive xanthomas are rare and often asymptomatic. On the other hand, these cutaneous lesions are a red flag for serious underlying metabolic disorders that demand an early diagnosis to prevent morbidity and mortality.

CASE REPORT: We report on two male patients, aged 23 and 27 years, who presented with eruptive xanthomas. Clinical, histological and laboratory investigations disclosed a metabolic syndrome in the younger patient and an alcohol-induced chylomicronemia in the elder one. Two types of macromorphology of cutaneous lesions were observed. Treatment was tailored according to underlying pathologies and resulted in significant improvement of the metabolic parameters and improvement of skin lesions.

CONCLUSION: Dermatologists should be aware of the diagnostic importance of eruptive xanthomas for serious metabolic disorders.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Zak A, Zeman M, Slaby A, Vecka M. Xanthomas: clinical and pathophysiological relations. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014; 158(2):181-8. https://doi.org/10.5507/bp.2014.016 PMid:24781043

Smith KJ, Yeager J, Skelton HG. Histologically distinctive papular neutrophilic xanthomas in HIV-1+ patients. Am J Surg Pathol. 1997; 21(5):545-9. https://doi.org/10.1097/00000478-199705000-00006 PMid:9158678

Santiago L, Pinho A, Cardoso JC. Eruptive xanthomas: a cardinal manifestation of the serious metabolic disease. Acta Med Port. 2018; 31(4): 219-22. https://doi.org/10.20344/amp.9126 PMid:29855416

Zabeen B, Khaled Z, Nahar J, Baki A, Amin F, Akhter S, Begum T, Azad K, Nahar N. Hypertriglyceridemia associated with eruptive xanthomas and lipemia retinalis in newly diagnosed diabetes mellitus. Mymensingh Med J. 2013; 22(3):591-5. PMid:23982556

Brazzelli V, Rivetti N, Carugno A, Barruscotti S, Croci GA, Perani G, Borroni G. Eruptive xanthomas after extensive tattooing: a case report and literature review. G Ital Dermatol Venereol. 2015; 150(6):770-1. PMid:25014584

Gao H, Chen J. Eruptive xanthomas presenting in tattoos. CMAJ. 2015; 187(5):356. https://doi.org/10.1503/cmaj.140383 PMid:25623644 PMCid:PMC4361110

Saraceno R, Dattola A, Pietroleonardo L, Pitocco R, Fida M, Chimenti S. Eruptive xanthomas and pancreatitis: clinical, dermatoscopy, confocal and pathological correlation. G Ital Dermatol Venereol. 2017; 152(4):394-6. PMid:28621119

Seremet S, Gurel MS. Miscellaneous skin disease and the metabolic syndrome. Clin Dermatol. 2018; 36(1):94-100. https://doi.org/10.1016/j.clindermatol.2017.09.016 PMid:29241760

Machado PV, Daxbacher EL, Obadia DL, Cunha EF, Alves Mde F, Mann D. Do you know this syndrome? Berardinelli-Seip syndrome. An Bras Dermatol. 2013; 88(6):1011-3. https://doi.org/10.1590/abd1806-4841.20132178 PMid:24474121 PMCid:PMC3900363

Zakon SJ, Oyamada A, Rosenthal IH. Eruptive xanthoma and hyperlipemia in glycogen storage disease (von Gierke's disease). AMA Arch Derm Syphilol. 1953; 67(2):146-51. https://doi.org/10.1001/archderm.1953.01540020024005 PMid:13029898

Gagné C, Brun LD, Julien P, Moorjani S, Lupien PJ. Primary lipoprotein-lipase-activity deficiency: clinical investigation of a French Canadian population. CMAJ. 1989; 140(4):405-11. PMid:2914262 PMCid:PMC1268664

Giry C, Giroux LM, Roy M, Davignon J, Minnich A. Characterization of inherited scavenger receptor overexpression and abnormal macrophage phenotype in a normolipidemic subject with planar xanthomas. J Lipid Res. 1996; 37(7):1422-35. PMid:8827515

Patel KM, Strong A, Tohyama J, Jin X, Morales CR, Billheimer J, Millar J, Kruth H, Rader DJ. Macrophage sortilin promotes LDL uptake, foam cell formation, and atherosclerosis. Circ Res. 2015; 116(5):789-96. https://doi.org/10.1161/CIRCRESAHA.116.305811 PMid:25593281 PMCid:PMC4602371

Ye Q, Lei H, Fan Z, Zheng W, Zheng S. Difference in LDL receptor feedback regulation in macrophages and vascular smooth muscle cells: foam cell transformation under inflammatory stress. Inflammation. 2014; 37(2):555-65. https://doi.org/10.1007/s10753-013-9769-x PMid:24297394

Published

2018-11-21

How to Cite

1.
Wollina U, Koch A, Hansel G, Schönlebe J. Eruptive Xanthomas – Two Case Reports With Distinct Features. Open Access Maced J Med Sci [Internet]. 2018 Nov. 21 [cited 2024 Apr. 25];6(11):2152-4. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.458

Issue

Section

C- Case Reports

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>