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June 1970


Author Affiliations

University Hospital Rijnsburgerweg 10 Leiden, Holland

Arch Dermatol. 1970;101(6):701-702. doi:10.1001/archderm.1970.04000060073020

To the Editor.—  The difference in opinion between Dr. Cornelius and ourselves seems to be simply a semantic one. Our intention was to stress that tuberous xanthomata are by no means specific for primary hyperbetalipoproteinemia ("essential or primary hypercholesterolemia"), as was accepted formerly. We could also have formulated our view in the following way: "tuberous xanthomata occur in primary hyperlipoproteinemia, independent from its type."Already in 1963 Lever1 pointed out that xanthomata tuberosa are found as well in primary hypercholesterolemia as in idiopathic hyperlipemia.We certainly did not discredit the eruptive xanthomata as diagnostic for hyperpre-β-lipoproteinemia. We deem it, however, impossible at this moment to prove or disprove which lipid, found in excess in primary hyperpre-β-lipoproteinemia, causes the xanthoma formation.Finally we completely agree with Dr. Cornelius that the presence of tuberous xanthomata is an absolute indication for an examination of the blood for total lipids, cholesterol, and triglycerides

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