Eruptive xanthomas: a case report with literature review focusing on pathogenesis and clinical management

A typical case of eruptive xanthomas secondary to untreated type 2 diabetes mellitus complicated with severe hyperlipidemia was reported. The patient had a history of acute pancreatitis one month before the onset of xanthomas. Laboratory tests revealed high levels of triglycerides, cholesterol, blood glucose, and acute inflammatory markers. Histopathological examination showed the foam cells in the dermis. After interventions, including a low-fat and low-carbohydrate diet, anti-diabetic therapy and lipid-lowering therapy, the patient's skin lesions partially resolved within two months. At the same time, all laboratory indicators improved. In addition, a comprehensive literature review was conducted on the pathophysiological mechanisms, key clinical diagnostic points, triglyceride level thresholds, and main treatment strategies of eruptive xanthomas. This study emphasizes that eruptive xanthomas and acute pancreatitis are clinical manifestations induced by severe hypertriglyceridemia. For dermatologists, the occurrence of eruptive xanthomas should be used as a trigger to screen for dyslipidemia to effectively prevent life-threatening severe complications.