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| Fig. 36.7 A, Eruptive xanthomas demonstrating typical yellow-brown papules. This patient’s triglyceride level was 7760. B, Tuberous xanthoma manifesting as a large nodular xanthoma of the knee. (Courtesy of James E. Fitzpatrick, MD.) |
Tuberous xanthomas are larger and deeper than eruptive xanthomas and may be palpated as nodules similar to a large radish, a small turnip, or other vegetable tuber or root within the deep dermis or subcutaneous fat (Fig. 36-7B). These xanthoms are the result of cholesterol accumulation within these tissues, in contrast to the smaller, papular, eruptive xanthomas that contain triglyceride. Tuberous xanthomas are a marker of high cholesterol levels, and these patients are at risk for coronary artery disease at a young age. Tendinous xanthomas (e.g., similar lesions attached to large tendons, such as the Achilles tendon) may also be present.
