PSEUDOXANTHOMA ELASTICUM.

Diagnosis: PSEUDOXANTHOMA ELASTICUM.

Case submitted by Dr.Azeem Alam Khan to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Dr.Azeem Alam Khan. Originally posted June 10, 2009.

Treatment

See case discussion.

Differential Diagnosis

• Xanthelasma • Juvenile xanthogranuloma • Granuloma annulare • Molluscum contagiosum • Lipoma • Dermatofibroma

Key Learnings

• Deposition of lipid-laden macrophages (foam cells) in skin • Types: eruptive, tuberous, tendinous, planar, xanthelasma palpebrarum • Eruptive xanthomas: sudden onset of yellow papules — associated with severe hypertriglyceridemia (>1000 mg/dL) • Tendinous xanthomas: pathognomonic for familial hypercholesterolemia (Achilles, hand extensors) • Xanthelasma: ~50% have normal lipids — but still screen • Full lipid panel is essential in all patients with xanthomas • Treatment of underlying hyperlipidemia leads to resolution of eruptive xanthomas

Tags: pseudoxanthoma, elasticum, dr.azeem alam khan