Xanthome eruptive E78.2

Rapidly occurring in large numbers, disseminated over the body, papular, yellow xanthomas with an inflammatory halo. Xanthomas are marker lesions for various lipid metabolic disorders. They are not strictly correlated with lipid metabolism disorders(diffuse normlipemic xanthomas - they belong to the family of xanthogranulomas).

Associations with Fredrickson's hyperlipoproteinemia type IV (E78.1) (see also Fredrickson's classification), chylomicronemia syndrome (E78.3); familial hypertriglyceridemia (E78.1); diabetes, chronic alcohol use, nephrotic syndrome, pancreatitis, medications, and pregnancy have been described.

Children and young people, adults: 20-60 years

Mainly glutaeal region, extremity extensor sides.

Within a few weeks exanthematically shooting up, multiple, 0.2-0.3 cm large, disseminated, flat raised, symptomless or slightly itchy, yellow or red, surface smooth, firm, sharply edged nodules. The nodules may aggregate in places, resulting in mulberry-like formations. Linear alignment of the nodules is also possible (Köbner phenomenon).

Acute pancreatitis, diabetes mellitus, reactive cardiovascular diseases

Cosmetically disturbing xanthomas can be removed surgically, also by means of laser, curettage or ablation with the electric loop. If necessary, dabbing with trichloroacetic acid (e.g. as ready-to-use drug: Solco Derman or as Rezetpur:trichloroacetic acid solution 10/20/35/50% (NRF 11.133.)).

Detection and treatment of the metabolic disorder. First of all, dietetic measures and lifestyle modifications (weight reduction, abstinence from nicotine, increase physical activity) should be taken and, in the absence of improvement, adjustment to lipid reducers should be made.

The lipoproteins of the plasma consist of lipids (triglycerides, fats, cholesterol and phospholipids) and apolipoproteins. Disorders of lipid metabolism are often found together with a metabolic syndrome, obesity, impaired glucose tolerance or insulin resistance, hypertriglyceridemia, reduction of HDL cholesterol and arterial hypertension.

1. Chang HY et al (2003) Eruptive xanthomas associated with olanzapine use. Arch Dermatol 139: 1045-1048
2. Digby M et al (2011) Eruptive xanthomas as a cutaneous manifestation of hypertriglyceridemia: a case report. J Clin Aesthet Dermatol 4:44-46.
3. Jaber PW et al (1992) Eruptive xanthomas during pregnancy. J Am Acad Dermatol 27: 300-302.
4. Kala J et al (2012) Images in clinical medicine. Eruptive xanthoma. N Engl J Med 366:835
5. Kuo CC et al (2011) Diabetic eruptive xanthoma. Acta Clin Belg 66:321-322
6. Makdsi F et al (2010) Acute pancreatitis with eruptive xanthomas. J Hosp Med 5:115
7. Merola JF et al (2008) Eruptive xanthomas. Dermatol Online J 14:10
8. Seward JL et al (2004) Generalized eruptive histiocytosis. J Am Acad Dermatol 50: 116-120.
9. Vogl A et al (2005) Skin and alcohol. J Dtsch Dermatol Ges 3: 788-790
10. Zahorcsek Z et al (1995) Successful treatment of eruptive xanthomatosis with acipimox. Dermatologist 46: 124-126