Eruptive Xanthomata Manifesting in Tattoos

Abstract

Eruptive xanthomata represent a rare, but important pruritic dermatosis for which an accurate diagnosis can prevent life-threatening complications. We present the case of a 29-year-old female with no prior medical history who presented to clinic for evaluation of a pruritic papular eruption of 2 weeks' duration. Notably, examination revealed numerous papules within the boundaries of her long-standing tattoos. Biopsy of these lesions revealed a diagnosis of eruptive xanthomata. Eruptive xanthomata are observed in the setting of extreme hypertriglyceridemia (> 3000 mg/dL) and, importantly, they koebnerize to areas of acute and past trauma. Examination of tattoos is vital in dermatologic practice as changes, particularly induration, can be suggestive of systemic disease. This case emphasises that the differential of koebnerization within tattoos should include eruptive xanthomata.