Eruptive Xanthoma With Pancytopenia: A Report of a Rare Case and Diagnostic Challenges

Eruptive xanthomas (EXs) are yellowish-orange papulonodular cutaneous eruptions typically associated with severe hypertriglyceridemia. We present a case of a 40-year-old female with poorly controlled diabetes mellitus (DM) who developed EX concurrent with pancytopenia. The patient presented with epigastric discomfort, emesis, and generalized cutaneous eruptions. Laboratory findings revealed severe dyslipidemia, pancytopenia, and elevated liver enzymes. Imaging studies indicated interstitial pancreatitis (IP). Despite aggressive multimodal therapy, including immunosuppressive treatments and blood product support, the patient's condition deteriorated rapidly. The pancytopenia persisted, and the patient developed aplastic anemia (AA), ultimately resulting in fatal complications despite aggressive management. This case highlights a potential association between severe dyslipidemia, cutaneous manifestations, and bone marrow dysfunction. Further research is warranted to elucidate the mechanisms linking severe dyslipidemia with hematopoietic dysfunction and to explore potential therapeutic targets that address both the metabolic and hematological aspects of these disorders.