Introduction: Eruptive Xanthomas are rare manifestations of severe hypertriglyceridemia presenting as multiple erythematous to yellowish dome-shaped papules, commonly involving the extensor surfaces and buttocks. Prompt multidisciplinary recognition is vital given the associated risks of atherosclerosis and pancreatitis.

Case Report: A 46-year-old Filipino male presented with a 7-month history of asymptomatic whitish to yellowish dome-shaped papules on the nape, trunk, lower back and extremities. Previously treated by a private dermatologist as a case of Molluscum Contagiosum using topical 5% potassium hydroxide with no relief, he was then consulted through teledermatology, where xanthomatous disease was suspected, prompting physical consultation. Examination revealed multiple 2 to 4 mm, well-defined yellowish to whitish papules and nodules, some clustered, on the trunk, abdomen, arms and legs. He had Stage II Hypertension (140/90 mmHg) and a BMI of 29.8 kg/m² (Obese I). Laboratory evaluation showed a marked 16.8-fold elevation of his triglycerides at 2,450.57 mg/dl (27.67 mmol/L), with elevations in his fasting blood sugar, liver enzymes, low density lipoprotein and very low density lipoprotein. He was referred to an internist, and was managed with lifestyle changes, Fenofibrate 160mg/cap daily, Teneligliptin 40mg/tab daily, Atorvastatin 40mg/tab daily, Carnitine Orotate + Hepatic Extract Antitoxic Fraction + Adenine HCl + Multivitamins tablet thrice daily, and Amlodipine 10mg/tab daily. Lesions decreased in number, with increase in hyperpigmentation and reduced yellowish discoloration on dermoscopy.

Conclusion: Although uncommon, asymptomatic lesions like eruptive xanthomas may signal metabolic diseases, underscoring the importance of prompt recognition, referral and treatment.

Keywords: Eruptive Xanthoma, Dyslipidemia, Case Report

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