DOI: 10.36347/sjmcr.2020.v08i07.021

Pages: 734-737

Case Report: A 28-year-old female presented with multiple subcutaneous nodules since last five years. Initially, lesions started on the back, hands and gluteal region. They were slowly progressive, persistent and asymptomatic. Patient was unmarried and her only concern was cosmetic appearance, so she underwent excisional biopsy of the lesion from gluteal region in our hospital. Routine haematological investigations and coagulation profile was normal. Grossly, we received yellowish, soft, cheesy mass measuring 1.8 x 1.1 x 1.0 cm. Cut section showed soft, yellowish, cheesy areas. Microscopic study revealed skin showing epidermis and dermis lined by stratified squamous epithelium. Epidermis was thin with no dysplasia. Dermis showed diffuse infiltration of foamy macrophages along with many classical Tuoton type giant cells. Based on these findings and clinical details, diagnosis of tuberous xanthoma was offered. Discussion: Xanthoma is a localised collection of tissue histiocytes containing lipids. It is a pseudotumor which particularly occurs in response to alterations in lipid metabolism. Tuberous xanthomas generally present as discrete painless nodules or large plaque like lesions of the subcutis. In our patient, lipid profile was found to be deranged and cholesterol was on higher side i.e. 380mg/dl. Because of prompt diagnosis, patient was shifted on cholesterol lowering agents to prevent cardiovascular complications. Conclusion: In conclusion, we are presenting a case of Multiple Tuberous Xanthomas in a young female not only for its histopathological diagnosis but also for putting more emphasis on correction of lipid profile through prompt administration of cholesterol lowering agents. This will lower the risk of mortality due to cardiovascular complications.