ERUPTIVE XANTHOMA
ERUPTIVE XANTHOMA ICD-10: E78.220
• These discrete inflammatory-type papules “erupt” suddenly and in showers, appearing typically on the buttocks, elbows, lower arms (Fig. 15-12), and knees.
• A sign of FHT, FD, the very rare familial lipoprotein lipase deficiency (Table 15-2), and out of control diabetes.
• Papules are dome shaped, discrete, initially red, then yellow center with red halo (Fig. 15-12).
• Lesions may be scattered, discrete, in a localized region (e.g., elbows, knees [Fig. 15-12], and buttocks) or appear as “tight” clusters that become confluent to form nodular “tuberoeruptive” xanthomas.
• Management: React very favorably to a low-calorie and low-fat diet.
A B
FIGURE 15-12 • Papular eruptive xanthomas (A) Multiple, discrete, red-to-yellow papules becoming confluent on the knees of an individual with uncontrolled diabetes mellitus; lesions were also present on both elbows and buttocks. (B) Higher magnification of xanthomas on the trunk of another patient.
TABLE 15-2 Clinical Presentations of Xanthomas