Eruptive xanthomas are small lesions and bumps that appear on the skin. They can be yellow, pink, brown, or skin-colored and may sometimes be itchy and painful. While eruptive xanthomas are not harmful, they may be a sign of an underlying condition, such as diabetes.
In this article, we discuss eruptive xanthomas in more detail, including their causes, symptoms, and treatment. We also look at their relationship with diabetes.
What are eruptive xanthomas?
Eruptive xanthomas are benign lesions that appear on the skin and consist of lipid, or fatty acid, deposits.
They are uncommon and can appear alongside other conditions. As a result, they may be an early warning sign of another illness that affects the metabolism, such as diabetes.
Causes
Eruptive xanthomas occur as a result of lipid deposits in the skin.
They can develop due to hypertriglyceridemia, which refers to high levels of serum triglycerides, a type of lipid in the blood.
Some conditions that can also cause high levels of serum triglycerides, potentially leading to eruptive xanthomas, include:
- having obesity
- diabetes
- alcohol use
- hypothyroidism
Symptoms
According to a 2018 article, eruptive xanthomas are often asymptomatic, meaning that people do not experience any symptoms apart from the appearance of the lesions. However, if symptoms are present, a person may experience itchiness and, in some cases, pain.
The lesions appear as small shiny bumps that are typically 1–4 millimeters in size.
Eruptive xanthomas usually appear on the buttocks, shoulder, arms, and legs. However, people may notice the bumps and lesions all over the body, including on the face and inside the mouth.
Treatment
To treat eruptive xanthomas, a doctor must diagnose and treat the underlying condition that is causing them.
The symptoms and appearance of xanthomas should lessen or go away entirely once a person receives treatment for the underlying condition.
As well as medications, healthful dietary changes and increased physical activity can help treat eruptive xanthomas.
Dietary and exercise changes
DermNet state that people may find that changing their diet helps reduce the symptoms of eruptive xanthomas.
People may benefit from:
- ensuring that a large part of their diet consists of vegetables, salads, cereals, and fish
- reducing their consumption of saturated fats, such as meat, dairy products, and coconut and palm oil
- reducing their consumption of sugars present in fizzy drinks, sweets, biscuits, and cake
People with overweight or obesity may also find that slowly reducing their calorie intake and increasing their physical activity helps reduce symptoms.
Medical treatment
Eruptive xanthomas sometimes go away by themselves within a few weeks with the above modifications. However, if they do not, a doctor may prescribe several different medications, including the following:
| Medication | How it works |
|---|---|
| Statins | These drugs reduce cholesterol production in the liver. They also mildly reduce triglycerides. |
| Fibrates | Doctors may prescribe fibrates alongside statins. They reduce triglyceride production in the liver. |
| Ezetimibe (Zetia) | This drug may be more suitable for people at high risk of complications. It reduces the amount of cholesterol in the gut. |
| Nicotinic acid | Nicotinic acid reduces cholesterol and triglycerides. |
If the xanthomas do not resolve spontaneously or following treatment of the underlying condition, surgery may be an option.
Diabetes and eruptive xanthomas
Diabetes is a long-term condition that affects the production or function of insulin in the body.
A 2018 article mentions that people with untreated type 2 diabetes experience a decrease in lipoprotein lipase activity, which plays an important role in breaking down fats in the blood. They will also experience an increase in serum triglycerides, or fat.
If the levels of serum triglycerides are high enough, lipids will cause eruptive xanthomas.
Therefore, those with diabetes have a higher chance of eruptive xanthomas.
Although eruptive xanthomas are more common in people with type 2 diabetes, they can still affect those with type 1 diabetes.
According to an article in the British Journal of Diabetes, if a person with eruptive xanthomas has diabetes, a doctor may not prescribe statins or fibrates until the person has control over their blood sugar levels.
It is important to note that not everyone who experiences eruptive xanthomas has diabetes. However, if eruptive xanthomas appear, it can be an indication that a person has developed diabetes.
Diagnosis
A doctor may perform a series of tests to diagnose eruptive xanthomas. They may perform a skin biopsy, which involves taking a small sample of an eruptive xanthoma and sending it to a lab for testing.
Doctors may also order blood and urine tests, as well as X-rays, to see whether they can diagnose any underlying conditions that may be causing the eruptive xanthomas.
It is important that doctors order these tests, as many underlying conditions can cause serious harm if a person does not receive treatment.
Outlook and complications
The skin lesions themselves are harmless, and they may resolve without medical intervention within a few weeks of appearing. However, they indicate an underlying condition that a person should address due to potential complications.
One such complication is a higher chance of developing pancreatitis due to the increase of serum triglycerides.
Pancreatitis is a condition that causes severe abdominal pain that may lead to nausea and vomiting.
If the eruptive xanthomas appear due to diabetes, a person should see a doctor. Without the correct treatment, the individual may experience complications due to diabetes. Untreated diabetes can even be fatal. The Centers for Disease Control and Prevention (CDC) state that diabetes is the seventh leading cause of death in the United States.
When to see a doctor
People should see a doctor if they notice the appearance of lesions resembling eruptive xanthomas.
Although the lesions are harmless, they indicate that a person has hypertriglyceridemia, which can be a warning sign of another long-term condition, such as diabetes.
A doctor will be able to test for and diagnose any underlying conditions and work out a treatment plan that helps manage and control the condition.
Summary
Eruptive xanthomas are small lesions that appear over the body as a result of fatty acids depositing themselves into the skin. Some people may experience itchiness and pain, but these symptoms do not affect most people.
Eruptive xanthomas will resolve when a person receives treatment for the underlying cause.
There are links between this condition and both type 1 and type 2 diabetes, due to the increase in levels of serum triglycerides. Doctors will diagnose and treat the underlying condition to treat the eruptive xanthomas.
Dietary changes and medications can also treat eruptive xanthomas. People should discuss any dietary changes and medication use with their doctor.
If a person has diabetes and eruptive xanthomas, a doctor may not prescribe statins or fibrates until the diabetes is under control.
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