An Unusual Rash in a Middle-Aged Man

Excerpt

A 46-year-old Caucasian male with a history of poorly controlled type II diabetes mellitus (DM) and hypertriglyceridemia presented with painless, non-pruritic bumps on his bilateral arms and knees for two weeks. Four weeks previously, the patient had been started on mirtazapine for post-traumatic stress disorder. He denied any past or family history of such rashes. On examination, his skin was remarkable for grouped pink to yellow, well-defined papules on the extensor surfaces of his elbows and knees (Fig. 1). The patient’s laboratory tests showed hyperglycemia (400 mg/dl) and severe hypertriglyceridemia (>3000 mg/dl). Based on his examination and laboratory findings, a diagnosis of eruptive xanthomas in the setting of severe hypertriglyceridemia was made.

…