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Unknown: Yellow plaques on the chest and arms present for greater than 6 years in an 80-year-old male

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Unknown: Yellow plaques on the chest and arms present for more than 6 years in an 80-year-old male
L Katie Morrison MD1, Isha E Lopez BS2
Dermatology Online Journal 17 (5): 11

1. Department of Dermatology, University ot Texas Health Sciences Center Houston, Houston, Texas. ktmoxie@gmail.com
2. School of Medicine, University of Texas Southwestern, Dallas, Texas



Case synopsis


Figure 1 Figure 2

An 80-year-old white male presented for evaluation of a six-year history of slowly increasing yellow skin lesions. He had no significant past medical history nor a family history of hypercholesterolemia or early cardiac deaths. He denied systemic complaints such as shortness of breath or chest pain.

On skin examination, a yellow papule near the lateral epicanthus and a yellow macule near the temple were present (Figure 1). Multiple, well-demarcated yellow skin plaques in sheets were noted on the arms and back (Figure 2). There was no involvement of his palms, tendon areas, or other parts of his skin.


Figure 3 Figure 4

Laboratory studies demonstrated normal electrolytes, calcium, creatinine, liver function tests, and lipid studies. Serum hemoglobin was low at 11.8. Platelet count and white blood cell count were normal. An intralesional skin biopsy was obtained for a Hematoxylin-Eosin (H&E) stain (Figures 3 and 4).

What is the diagnosis?



Answer







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