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January 1974

Intertriginous Xanthomas

Author Affiliations

Leiden, Holland

Arch Dermatol. 1974;109(1):99-100. doi:10.1001/archderm.1974.01630010071029

To the Editor.—  The paper of Peter Elias, MD, and Lowell A. Goldsmith, MD, titled "Intertriginous Xanthomata in Type II Hyperbetalipoproteinemia"1 compels the following remarks.We agree that the two patients described are presumably of the homozygous type IIa hyperlipoproteinemia classification, though the evidence is incomplete.It is known that in patients homozygous for the type IIa primary hyperlipoproteinemia of the provisional classification of the World Health Organization, the skin symptoms appear earlier, are more polymorphous, and more extensively developed than in patients who are heterozygous.3-5In our opinion, the differences in the clinical picture are due to the high levels of low density lipoproteins and to the anatomical differences in the skin of infants and children. This implies

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