Normolipaemic xanthomas in association with human immunodeficiency virus infection

Melanosis of the areola in dermoscopy

“…3,5,6 Type IA refers to abnormal accumulation of cholestanol and plant sterols found in cerebrotendinous xanthomastosis and betasitosteroliemia, respectively. 4,6 Type IB includes patients in whom alterations in the protein portion of various lipoproteins result in xanthelasmas and tuberous xanthomas.…”

Diffuse xanthomatous eruption

“…3 Under these circumstances, it is prudent to exclude occult malignancy (eg lymphoproliferative disorders and monoclonal paraproteinaemia) or infections (eg human immunodeficiency virus infection). 4 Solitary lesions necessitate enquiry about previous local trauma, dermatoses, or surgical operation for Köbner phenomenon might have happened.…”

Normolipemic xanthomas on the ears of an adolescent

“…6 Type II normocholesterolemic xanthomatoses includes diffuse planar lesions that arise on the face and trunk because of lymphoproliferative diseases, such as multiple myeloma, Waldenstrom's macroglobuliniemia, cryoglobulinemia, lymphoma, and benign monoclonal gammopathy. [3][4][5][6] Paraprotein interaction in lipoprotein metabolism may be responsible for this xanthoma formation. 4,6 For the third group, local dermal tissue abnormalities may trigger xanthoma formation.…”

“…4,6 For the third group, local dermal tissue abnormalities may trigger xanthoma formation. [3][4][5][6] Erythroderma, epidermolysis bullosa dystrophica, and febrile episodes associated with bright-red erythema of the skin incite inflammation altering vascular permeability so that lipoproteins may leak and be phagocytized by dermal histiocytes. 3,4,6 Such a mechanism is responsible for the eruptive xanthoma formation described by Eeckhout et al 3 in capillary leak syndrome, a well-known complication of sepsis.…”

“…[3][4][5][6][7] The first group (type I) includes xanthomas associated with altered lipoprotein content or structure. 3,5,6 Type IA refers to abnormal accumulation of cholestanol and plant sterols found in cerebrotendinous xanthomastosis and betasitosteroliemia, respectively. 4,6 Type IB includes patients in whom alterations in the protein portion of various lipoproteins result in xanthelasmas and tuberous xanthomas.…”