Abstract

Introduction

Xanthomas are benign lesions caused by localized lipid deposits in the skin, tendons and subcutaneous tissue. Clinically they are yellowish papules, nodules or plaques. They can present as early manifestations of some systemic disorders such as coronary artery disease, cerebrovascular accidents, hepatic steatosis and acute pancreatitis. The major forms of xanthomas associated with hyperlipidemia are eruptive, tuberous, tendinous and plain xanthomas. Early recognition and treatment of the underlying condition associated with xanthomas can decrease the morbidity and mortality.² Here we report a case of admitted patient of eruptive xanthomas with acute pancreatitis.

Case Presentation

A 24-year-old female patient presented to the outpatient department of surgery with sudden onset epigastric pain of 2 days duration which was radiating to back and associated with vomiting. On examination, she was found to have multiple scattered yellow papules over the upper and lower limb mainly over the extensor surfaces, buttocks and back. Historically, lesions were 10-15 days old and clinically asymptomatic. Ultrasound abdomen revealed bulky pancreas with heterogenous echogenicity and minimum peripancreatic fluid. Serum amylase and lipase levels were elevated to the level of 286u/l and 457u/l respectively. Diagnosis of mild acute pancreatits was made as there was no organ failure on laboratory investigations. There was no history alcohol and intake of any drug. All other possible causes of acute pancreatitis were sought but showed no relation. Her fasting lipid profile showed cholesterol levels of 247mg/dl and serum triglycerides levels were …..  Biopsy from the lesion revealed dense, diffuse infiltrate of sheets of foamy histiocytes without any accompanying inflammatory infiltrate in the dermis. The patient was started on fenofibrate 160mg and managed for mild pancreatitis as per protocol.