A 40-year-old woman presents with multiple translucent papules on the eyelids and periorbital skin that are yellowish in colour. She has mild elevation of total cholesterol. Biopsy shows collections of lipid-laden macrophages (foam cells) in the dermis. The primary lipid deposited in xanthelasma and eruptive xanthomas of hypertriglyceridaemia respectively are:

• A Triglycerides in xanthelasma; cholesterol in eruptive xanthoma
• B Both are cholesterol ester deposits
• C Cholesterol esters in xanthelasma; triglycerides in eruptive xanthoma ✓
• D VLDL remnants in both

Explanation

Xanthelasma (periorbital xanthoma) contains predominantly cholesterol esters in foam cells (macrophages) in the dermis, associated with hypercholesterolaemia (especially elevated LDL). Eruptive xanthomas occur in severe hypertriglyceridaemia (TG >1000 mg/dL) and contain predominantly triglycerides in macrophage foam cells; they appear as small, reddish-yellow papules on buttocks, elbows, and knees. This distinction helps correlate the xanthoma type with the underlying dyslipidaemia pattern (Type IIa vs. Type I/IV/V hyperlipoproteinaemia).

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.