Eruptive xanthoma (EX) is a serious systemic dyslipidemia with distinctive cutaneous features. Although the dermatologic manifestations are not in themselves serious, their presence may be the harbinger of serious visceral disease. EX is an uncommon disease with a near equal gender incidence, principally seen in two age groups with different predisposing factors. Among children and young adults genetic disturbances in lipid metabolism are largely responsible and include lipoprotein lipase deficiency and Type I and V hyperlipoproteinemia (1). In older adults, acute ethanol ingestion and endocrinologic disturbances including hypothyroidism and diabetes mellitus are often observed. Common to these clinical settings is the presence of serum hypertriglyceridemia and/or elevated very low-density lipoproteins (VLDL) (2). Triglycerides are transported in the serum as a composite, known as a chylomicron, consisting of lipid with the apolipoproteins B-48, C-II, C-III, E, A-I, and A-IV. The apolipoproteins are critical in the metabolism of the chylomicrons. Chylomicrons are synthesized in the intestine and circulate in the serum, passing off triglycerides to the peripheral tissue endothelial capillaries via the enzymatic action of lipoprotein lipase and the binding of apolipoprotein C-II.
KeywordsAcute Pancreatitis Foam Cell Lipoprotein Lipase Granuloma Annulare Dermatologic Manifestation
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- 2.Parker F. The hyperlipidemias. In BH Thiers, RL Dobson (eds.), Pathogenesis of Skin Diseases. New York: Churchill Livingstone, 1986, 358–362.Google Scholar