Innumerable eruptive yellow papules.

ERUPTIVE XANTHOMAS

Eruptive Xanthomas (EX) are diffuse, multiple xanthomas deposited in the skin from acute elevation in blood triglycerides.

Conditions which predispose to this eruption include diabetes mellitus, chronic renal failure, nephrotic syndrome, hypothyroidism, alcohol ingestion, underlying hypertriglyceridemia and certain drugs (e.g., isotretinoin).

Clinical

A widespread, symmetric eruption of yellow papules with preference for the knees, elbows, and buttocks occurs in eruptive xanthomas. Patients should be evaluated for pancreatitis as the hypertriglyceridemia can induce this as well.

Ten percent of acute pancreatitis cases are triggered by hypertriglyceridemia exceeding 2,000 mg/dL (22.60 mmol/L). The risk of developing acute pancreatitis is approximately 5% with serum triglyceride levels > 1,000 mg/dL (> 11.3 mmol/L) and 10% to 20% with triglyceride levels > 2,000 mg/dL (> 22.6 mmol/L); the risk increases progressively with serum triglyceride levels higher than 500 mg/dL (5.65 mmol/L).

Treatment

The cutaneous eruption resolves within weeks, once the hypertriglyceridemia is corrected.

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