Case Presentation
A 93-year-old woman presented with confluent yellow plaques with an intense golden glow symmetrically on the neck and lateral face (Figure 1, A and B) mimicking a golden camouflage. The histopathology showed CD68-positive foamy macrophages in the papillary dermis (Figure 1, C and D), leading to the diagnosis of plane xanthoma. Our patient showed mild dyslipidemia (total cholesterol 6.4 mmol/l [<5.0 mmol/l]). Clinical stigmata for familial hyperlipidemia were not present. Due to the distribution pattern, underlying hematological disorders were ruled out.
Figure 1.
(A, B) Remarkable presentation of plane xanthoma on the neck and lateral face with a golden hue in a 93-year-old woman. (C, D) Histopathology of plane xanthoma with CD68-positive foamy macrophages in the papillary dermis.
Teaching Point
The location of plane xanthomas can serve as a clue to a particular underlying disease. Plane xanthomas in a normolipemic patient with favored distribution on the neck, upper trunk, and flexural folds should prompt a search of underlying hematological disorders such as monoclonal gammopathy or lymphoproliferative disease [1,2]. Plane xanthomas can precede such disorders by several years; therefore, a regular follow-up is recommended.
Footnotes
Funding: None.
Competing interests: The authors have no conflicts of interest to disclose.
Authorship: All authors have contributed significantly to this publication.
References
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