Normolipemic papular xanthoma with xanthelasma

Area of Science:

• Dermatology
• Endocrinology
• Lipid Metabolism

Background:

• Xanthomas are skin deposits indicating lipid metabolism disorders, often linked to high cholesterol.
• Xanthelasma typically appears on eyelids; papular xanthomas can manifest elsewhere on the body.

Observation:

• A 35-year-old woman presented with xanthelasma on her upper eyelids and papular xanthomas on her body.
• Initial investigations, including systemic examination and lipid profile, were normal.
• Serum protein electrophoresis also showed a normal pattern.

Findings:

• Histopathology of a papular lesion revealed characteristic foamy histiocytes and Touton giant cells.
• The patient was diagnosed with normolipemic papular xanthoma and xanthelasma.
• This presentation is exceptionally rare, occurring without elevated blood lipid levels.

Implications:

• This case underscores that xanthomas can occur even with normal lipid profiles, suggesting other underlying mechanisms.
• It highlights the importance of histopathological examination for diagnosing xanthoma variants.
• Further research into normolipemic xanthoma is warranted to understand its etiology and management.