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Palmar Striated Xanthomas in Clinical Practice.

Nathalie Roy1, Daniel Gaudet1, Diane Brisson1

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Palmar striated xanthomas (PSX), yellow skin lesions, appear in various lipid disorders beyond dysbetalipoproteinemia. These signs indicate remnant lipoprotein accumulation and warrant broader diagnostic consideration.

Keywords:
apolipoprotein Edysbetalipoproteinemiadyslipidemia diagnosispalmar striated xanthomasremnant lipoproteins

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Area of Science:

  • Lipidology
  • Dermatology
  • Clinical diagnostics

Background:

  • Palmar striated xanthomas (PSX) are characteristic of dysbetalipoproteinemia, linked to triglyceride-rich lipoprotein remnants.
  • The presence of PSX in other lipid disorders with remnant accumulation has not been systematically evaluated.

Purpose of the Study:

  • To assess the occurrence of PSX across a broad spectrum of lipid disorders.
  • To investigate PSX prevalence in conditions ranging from severe hypercholesterolemia to severe hypertriglyceridemia.

Main Methods:

  • A cohort of 3382 adult patients with diverse lipid disorders was studied.
  • Statistical analyses included Pearson chi-squared, ANOVA, and Kruskal-Wallis tests.

Main Results:

  • PSX were present in 5.1% of all patients, predominantly women (67.1%).
  • PSX occurred in 18.8% of dysbetalipoproteinemia patients, 14.1% with partial lipoprotein lipase deficiency, 3.7% with chylomicronemia, and 100% with homozygous familial hypercholesterolemia.
  • 10.7% of PSX patients did not meet dysbetalipoproteinemia criteria.

Conclusions:

  • PSX prevalence in patients without dysbetalipoproteinemia is estimated around 10%.
  • PSX can be observed in various lipid disorders associated with remnant lipoprotein accumulation, suggesting broader clinical significance.