Eruptive xanthoma revealing severe metabolic syndrome in an Indonesian adolescent case report: the critical role of early diagnosis and multidisciplinary management

A 16-year-old female presented with rapidly spreading yellowish-red papules on her trunk and extremities, accompanied by longstanding polyuria, polydipsia, and polyphagia. Family history revealed diabetes and dyslipidemias. Examination revealed overweight status and typical xanthomatous papules. Laboratory evaluation showed severe hypertriglyceridemia (2.988 mg/dl), elevated cholesterol (cholesterol 319 mg/dl), and poorly controlled diabetes mellitus (HbA1c 13.9%). Skin biopsy demonstrating lipid-laden foamy histiocytes (foam cells) underlying confirmed diagnosis of eruptive xanthoma. The aims to highlight the diagnostic value of eruptive xanthoma as an early marker of life-threatening metabolic dysfunction in adolescents and to emphasize the importance of multidisciplinary management. The patient received a multidisciplinary approach by fibrates, statins, insulin, metformin, intensive dietary and lifestyle modification, and topical moisturizer. Lesions resolved within 3 months as metabolic parameters improved. This rare case underlines the critical importance of recognizing eruptive xanthoma as an early warning sign of serious metabolic disease in adolescents. Early detection and a multidisciplinary management strategy are essential to prevent life-threatening complications.