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Multiple xanthoma tuberosum!!

Photograph of patient's knee showing multiple xanthoma tuberosum!! What you see are sharply demarcated yellowish collection of cholesterol underneath the skin, which develop in the setting of altered systemic lipid metabolism or as a result of local cell dysfunction. They consist of foam cells; these specific cells are formed from macrophages as a result of an excessive uptake of low density lipoprotein (LDL) particles and their oxidative modification. Xanthomas are usually located around the eyelids. Xanthoma tuberosum on the other hand is characterized by xanthomas located over the joints. All nodular dermal lesions are associated with increased cardiovascular risk and reduced average lifespan, especially in patients with familial hypercholesterolemia or dysbetalipoproteinemia. Treatment consists of simple excision of the mass in case of compromised function with a trichloroacetic acid peel, surgery, lasers or cryotherapy, as well as treatment of the underlying hyperlipidemia.