Lipid Lakes in Eruptive Xanthoma

Abstract

Introduction: The diverse pathological manifestations of eruptive xanthomatosis may be related to the clinical features and prognosis of this skin disorder. We herein report a case of eruptive xanthomatosis that exhibited a special pattern called “lipid lakes” under hematoxylin–eosin staining. Case Presentation: A 31-year-old woman who had been diagnosed with eruptive xanthomatosis and severe metabolic syndrome was admitted to our clinic. Her histopathologic examination showed abundant cholesterol deposition, forming a special pattern called “lipid lakes.” Most of the skin lesions shrunk after only 4 days of hypoglycemic and lipid-lowering treatment and disappeared during long-term follow-up; such a treatment response is rare. Discussion: Eruptive xanthomas are caused by the escape of lipid from the circulation to the interstitial spaces of connective tissues. The formation of “lipid lakes” is caused by rapid lipid exudation and may serve as a new marker of disease activity. Notably, “lipid lakes” may be reabsorbed relatively easily, indicating a good prognosis. Conclusion: As a new histopathological pattern of eruptive xanthomatosis, “lipid lakes” can be a marker of disease activity and indicate a good prognosis.