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Eruptive Xanthoma in a Diabetic. Presented by the Staff of Detroit General Hospital.
A 45-year-old white woman subject to grand mal seizures and taking phenobarbital and diphenydantoin (Dilantin) since age 20 presented herself with a history of polydipsia, polyuria, and a showering of yellowish skin lesions of approximately one year in duration.Examination revealed an obese woman in acute distress with multiple firm yellow papules, 2-5 mm in diameter, and distributed freely over the neck, chest, abdomen, back, arms, and legs. The lesions were nontender and showed little clinical evidence of infiltration.The significant laboratory studies were reported as: fasting blood sugar 656 mg/100 cc serum acetone 3+ undiluted, CO2 11.2 megacycle/liter, total serum lipids 13,000 mg/100 ml, and total cholesterol 625 mg/100 ml.The biopsy of a papule revealed a dermal mass consisting of many foamy and reticulated cells with a sprinkling of giant cells throughout the section.