Eruptive Xanthoma

Eruptive Xanthomas on the knee

Eruptive Xanthomas on the knee

Eruptive Xanthomas are yellow papules commonly found on extensor surfaces and buttocks, in this case secondary to extreme hypertriglyceridemia (extreme is defined as triglycerides >4428)

Causes of Hypertriglyceridemia:

     Primary:

               Type I hyperlipoproteinemia (type I)

               Mixed hypertriglyceridemia (type V)

               Familial dysbetalipoproteinemia (type III)

     Secondary:

               Uncontrolled DM

               Medications (BBs, estrogen, tamoxifen, protease inhibitors, glucocorticoids)

               EtOH consumption

               Hypothyroidism

               Nephrotic Syndrome

               ESRD

               SLE

Patients with TG>2000 almost always have both a primary and secondary form of hypertriglyceridemia

 

Acute Management of extreme hypertriglyceridemia:

               -Fluids!

               -NPO vs No/low fat diet (see review of topic here)

               -Insulin ggt if they are hyperglycemic