Pleomorphic cutaneous xanthomas disclosing homozygous familial hypercholesterolemia

Figure 3 Diffuse intertriginous xanthomas. Usually appear in a symmetric distribution as well-demarcated and slightly elevated noninflammatory plaques of ochre-yellow or yellow-brown discoloration. Typically found in intertriginous and flexural areas. A: In finger web spaces, and in this picture with metacarpophalangeal joint tendon xanthoma; B: At metacarpophalangeal palmar crease in linear band or single papules; C: Toe web spaces; D: In toe web spaces and ankle crease; E and F: At antecubital fossae, with the “eruptive” appearance of crops of yellow dermal soft, velvety papules; G and H: In popliteal fossae; I and J: At the creases of ears in a rare pattern of “plane xanthoma” as very thin flat patches, easily clinically missed, of yellow-orange macular discoloration.