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January 2001

Multiple Umbilicated Papules on a Young Man

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Arch Dermatol. 2001;137(1):85-90. doi:

Both biopsy specimens showed similar findings: foamy histiocytes betweencollagen bundles throughout the dermis and an associated sparse infiltrateof lymphocytes and neutrophils around superficial and deep venules. Lipidwas also present interstitially. These findings were consistent with eruptivexanthomas.

The patient was referred to the internal medicine department for furtherevaluation. Laboratory tests revealed the following values: serum glucose,14.3 mmol/L (258 mg/dL); triglycerides, 123.87 mmol/L (10 962 mg/dL)(reference range, 0.56-2.03 mmol/L [50-180 mg/dL]); and cholesterol, 30.46mmol/L (1176 mg/dL) (reference range, 3.37-5.70 mmol/L [130-220 mg/dL]). Hedenied any abdominal symptoms consistent with pancreatitis. His complete bloodcell count and liver function test results were within normal limits. Hiselectrolyte panel showed a slight metabolic acidosis. Thyroid function testswere not performed. His hyperglycemia did not respond to diet modification,and he eventually began insulin therapy, with improvement in his blood glucose,cholesterol, and triglyceride levels. During the next 6 months on this regimen,he also experienced an involution of some skin lesions.

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