Eruptive xanthomas in a patient with severe hypertriglyceridemia and type 2 diabetes

摘要

A 46-year-old man with obesity, hypertension, hyperlipidemia and bipolar disorder presented with a rash (Figure 1) accompanied by ongoing excessive urine production, excessive thirst and blurred vision. The lesions had appeared on his arms 1 month earlier and had spread to his neck, buttocks and legs. He was taking quetiapine and metoprolol. Both of the patient's parents had type 2 diabetes mellitus. A physical examination showed crops of firm yellow-red papules (diameter 1-3 mm) distributed on the patient's neck, bilateral extremities and buttocks, suggestive of eruptive xanthomas. Laboratory investigations showed elevated levels of triglycerides (64.2 [normal 0.6-2.8] mmol/L), cholesterol (18.2 [normal 3.1-5.2] mmol/L), acet-ylated hemoglobin (139.3 [normal 25.6-42.0] mmol/mol) and glucose (31.2 [normal 3.3-6.1] mmol/L). Results of kidney and liver function tests were normal, as were the results of tests for thyroid stimulating hormone, triiodothyronin, thy-roxin, amylase and lipase.