Xanthomas associated with dyslipidemias include eruptive xanthoma, tendinous xanthoma
, xanthoma palpebrarum, and xanthoma tuberosum (TABLE).
Pathogenesis of tendinous xanthoma
: histopathological study of the extremities of Watanabe heritable hyperlipidemic rabbits.
Diagnosis of heFH required evidence of the Simon-Broome criteria  except that we did not require evidence of tendinous xanthoma
in family members since xanthomas are prevented by early treatment and somewhat uncommon in young family members.
Case 13 had tendinous xanthoma, appearing as slowly enlarging, smooth, and firm subcutaneous nodules on the extensor surface of the forearm and case 14 had eruptive xanthoma.
Intertriginous xanthomas are rare, but pathognomonic of this disorder.22 Patients with hypertriglyceridaemia may also develop eruptive xanthoma.11 In our study, 14 cases presented with eruptive xanthomata and one who had tendinous xanthomas in the hypertriglyceridaemia group.
Differential diagnosis will be tendinous xanthoma
, necrobiotic granuloma, foreign body granuloma, epidermoid cyst, knuckle pad, fibroma of tendon sheath, lipoma and ganglion cyst .
Although cutaneous and tendinous xanthomas
occur in relation to hyperlipidemia, gastrointestinal xanthomas are not associated with dyslipidemia [3, 7, 13].
Figure 3: Photograph showing tendinous xanthomas
on the elbow.
The independent categorical variables were coded as follows: 1 for male and 0 for female, 1 for presence and 0 for absence of hypertension, 1 for presence and 0 for absence of arcus cornealis, and 1 for presence and 0 for absence of tendinous xanthomas
. The type of LDLR gene mutation was coded by use of 2 dummy categorical variables: null mutations vs missense mutations (1 for null mutations, 0 for splicing mutations, 0 for missense mutations) and splicing mutations vs missense mutations (0 for null mutations, 1 for splicing mutations, 0 for missense mutations).
Tuberous and Tendinous Xanthomas
are essentially identical.
Tuberous and tendinous xanthomas
both occur on the extensors of fingers and Achilles tendon.