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Case report, case study

Concomitant Hidradenitis Suppurativa and Eruptive Xanthomas Presenting with Phimosis – The Importance of Timely Diagnosis

Rune Kjærsgaard Andersen ; Department of Dermatology, Zealand University Hospital, Roskilde, & Health Sciences Faculty, University of Copenhagen, Denmark The Department of Dermatology, Zealand University Hospital is a part of the European Reference Network on Rare and Undiagnosed Skin Diseases
Shiva Yazdanyar ; Department of Dermatology, Zealand University Hospital, Roskilde, & Health Sciences Faculty, University of Copenhagen, Denmark The Department of Dermatology, Zealand University Hospital is a part of the European Reference Network on Rare and Undiagnosed Skin Diseases
Gregor Borut Ernst Jemec ; Department of Dermatology, Zealand University Hospital, Roskilde, & Health Sciences Faculty, University of Copenhagen, Denmark The Department of Dermatology, Zealand University Hospital is a part of the European Reference Network on Rare and Undiagnosed Skin Diseases
Ditte Marie Saunte ; Department of Dermatology, Zealand University Hospital, Roskilde, & Health Sciences Faculty, University of Copenhagen, Denmark The Department of Dermatology, Zealand University Hospital is a part of the European Reference Network on Rare and Undiagnosed Skin Diseases


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Abstract

A 49-year-old man diagnosed with metabolic syndrome (MetS) was referred
to us for treatment of xanthoma elements. Physical examination revealed
widespread confluent yellow firm papules on his fingers, toes, arms, legs, and back.
The diagnosis of eruptive xanthoma (EX) was clinically confirmed. During the examination
of scar tissues, tombstone comedones and an inflammatory nodule
was noted on his abdominal folds and right groin. These are diagnostic signs of
hidradenitis suppurativa (HS), a condition the patient had reportedly suffered for
15 years without being diagnosed. The patient’s HS nodule was treated with intralesional
triamcinolone injection, and prophylactic resorcinol was initiated, and he
was referred to endocrinologists for xanthoma management. Three weeks later he
returned due to newly developed lesions on his preputium, which caused a painful
phimosis. Both HS and EX are correlated with MetS and causes increased all-cause
cardiovascular mortality. As the average diagnostic delay of HS is 7.2 years, it is likely
that timely diagnosis of HS would have identified the patient as being at risk of
developing MetS. With proper preventive measures, the resulting EX lesions and
increase in cardiac mortality could have been avoided

Keywords

hidradenitis suppurativa, eruptive xanthoma, phimosis, case report, hypertriglyceridemia

Hrčak ID:

281291

URI

https://hrcak.srce.hr/281291

Publication date:

16.9.2020.

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