The patient presents with xanthomas on the extensor tendons of the hand and the Achilles tendon. Xanthomas are usually a consequence of primary or secondary hyperlipidemia. Xanthomas are most commonly found in superficial soft tissues such as skin and subcutis or on extensor tendon sheaths. Xanthomas are often found in patients with genetic disorders resulting in altered lipid metabolism, including familial hypercholesterolemia. Initial treatment should target the underlying hyperlipidemia (when present) because hypolipidemic drug treatment often results in regression of the lesions.
Photo courtesy of: Hurst’s the Heart Explanation courtesy of: The Color Atlas of Family Medicine
Could it be RA with inflammation of the Achilles tendon?
ReplyDeletecalcinosis possibly 2/2 dermatomyositis or CREST
ReplyDeleteGreat guesses but neither are correct. Good job zeroing on an abnormality of the tendons...
ReplyDeleteAnswer:
ReplyDeleteThe patient presents with xanthomas on the extensor tendons of the hand and the Achilles tendon. Xanthomas are usually a consequence of primary or secondary hyperlipidemia. Xanthomas are most commonly found in superficial soft tissues such as skin and subcutis or on extensor tendon sheaths. Xanthomas are often found in patients with genetic disorders resulting in altered lipid metabolism, including familial hypercholesterolemia. Initial treatment should target the underlying hyperlipidemia (when present) because hypolipidemic drug treatment often results in regression of the lesions.
Photo courtesy of: Hurst’s the Heart
Explanation courtesy of: The Color Atlas of Family Medicine