Eruptive Xanthomas with Branching Projections

This Images in Clinical Medicine entry describes a 34 year old woman with obesity and untreated diabetes mellitus who presented with symmetric, pink yellow papules merging into branching projections on her trunk, buttocks, and limbs. Laboratory findings revealed severe hypertriglyceridemia (6349 mg/dL) and hyperglycemia (HbA1c 11.8%). Skin biopsy confirmed eruptive xanthomas, characterized by foamy macrophages and lipid deposits. The patient was treated with a low fat diet, fenofibrate, insulin, and oral antidiabetic agents, leading to resolution of lesions (with residual hyperpigmentation) within 6 months. The case underscores eruptive xanthomas as a cutaneous marker of severe metabolic derangement requiring urgent intervention to prevent complications like pancreatitis.

This Images in Clinical Medicine entry describes a 34 year old woman with obesity and untreated diabetes mellitus who presented with symmetric, pink yellow papules merging into branching projections on her trunk, buttocks, and limbs. Laboratory findings revealed severe hypertriglyceridemia (6349 mg/dL) and hyperglycemia (HbA1c 11.8%). Skin biopsy confirmed eruptive xanthomas, characterized by foamy macrophages and lipid deposits. The patient was treated with a low fat diet, fenofibrate, insulin, and oral antidiabetic agents, leading to resolution of lesions (with residual hyperpigmentation) within 6 months. The case underscores eruptive xanthomas as a cutaneous marker of severe metabolic derangement requiring urgent intervention to prevent complications like pancreatitis.